How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,000.00 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,000.00 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,000.00 | Professional | None | $707.95 | $1,000.00 | $1,000.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $11,220.18 | Facility | None | $1,621.81 | $3,801.89 | $11,220.18 |
BCBS South Carolina Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $912.01 | Professional | None | $549.54 | $549.54 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,511.89 | Facility | None | $602.56 | $1,819.70 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,659.59 | Professional | None | $575.44 | $724.44 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $3,019.95 | Facility | None | $398.11 | $1,000.00 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,000.00 | Professional | None | $676.08 | $851.14 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $851.14 Typical High $1,380.38 | Professional | None | $81.28 | $851.14 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $1,698.24 | Professional | None | $588.84 | $831.76 | $1,698.24 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $354.81 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $141.25 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $524.81 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $104.71 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $70.79 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $489.78 | $691.83 | $691.83 |
Where South Carolina sits
The same service costs 6.8 times more in Oklahoma than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
South Carolina· 42nd of 51
$912
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.