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 $794.33 Median $10,000.00 Typical High $21,877.62 | Facility | None | $794.33 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $794.33 | Professional | None | $562.34 | $794.33 | $794.33 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $4,168.69 Typical High $18,197.01 | Facility | None | $851.14 | $4,168.69 | $18,197.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $512.86 Median $977.24 Typical High $1,318.26 | Professional | None | $512.86 | $977.24 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,511.89 | Facility | None | $602.56 | $1,778.28 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,318.26 | Professional | None | $660.69 | $794.33 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $794.33 Typical High $2,137.96 | Facility | None | $616.60 | $794.33 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,445.44 | Professional | None | $724.44 | $1,023.29 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $660.69 Typical High $1,023.29 | Professional | None | $66.07 | $660.69 | $1,023.29 |
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 $562.34 Median $891.25 Typical High $1,412.54 | Professional | None | $562.34 | $891.25 | $1,412.54 |
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 $281.84 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $281.84 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $112.20 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $426.58 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $85.11 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $56.23 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $398.11 | $549.54 | $549.54 |
Where South Carolina sits
The same service costs 5.9 times more in Alaska than in Texas. 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· 44th of 51
$813
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.