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 $457.09 Median $741.31 Typical High $16,595.87 | Facility | None | $457.09 | $741.31 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $870.96 | Professional | None | $457.09 | $616.60 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,000.00 Median $3,890.45 Typical High $11,220.18 | Facility | None | $1,000.00 | $3,890.45 | $11,220.18 |
BCBS South Carolina Setting Professional Modifier None Typical Low $288.40 Median $660.69 Typical High $933.25 | Professional | None | $288.40 | $660.69 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $549.54 Typical High $1,122.02 | Facility | None | $281.84 | $549.54 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $1,258.93 | Professional | None | $512.86 | $741.31 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $724.44 Typical High $891.25 | Facility | None | $457.09 | $724.44 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $562.34 Median $912.01 Typical High $1,096.48 | Professional | None | $562.34 | $912.01 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $524.81 Typical High $851.14 | Professional | None | $81.28 | $524.81 | $851.14 |
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 $346.74 Median $676.08 Typical High $1,258.93 | Professional | None | $346.74 | $676.08 | $1,258.93 |
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 $204.17 Median $245.47 Typical High $338.84 | Professional | 52 · Reduced service | $204.17 | $245.47 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $97.72 Typical High $134.90 | Professional | 53 · Discontinued | $81.28 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $371.54 Typical High $512.86 | Professional | 54 · Surgery only | $302.00 | $371.54 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $74.13 Typical High $102.33 | Professional | 55 · Aftercare only | $60.26 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $48.98 Typical High $67.61 | Professional | 56 · Pre-op care only | $40.74 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $346.74 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $281.84 | $346.74 | $478.63 |
Where South Carolina sits
The same service costs 4.3 times more in Wisconsin 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· 34th of 51
$661
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.