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 $234.42 Median $5,623.41 Typical High $21,877.62 | Facility | None | $234.42 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $338.84 | Professional | None | $234.42 | $269.15 | $338.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $660.69 Median $1,071.52 Typical High $3,162.28 | Facility | None | $660.69 | $1,071.52 | $3,162.28 |
BCBS South Carolina Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $346.74 | Professional | None | $181.97 | $218.78 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $575.44 Typical High $977.24 | Facility | None | $331.13 | $575.44 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $537.03 | Professional | None | $223.87 | $302.00 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $204.17 Median $371.54 Typical High $851.14 | Facility | None | $204.17 | $371.54 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $416.87 | Professional | None | $269.15 | $323.59 | $416.87 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $309.03 Typical High $501.19 | Professional | None | $39.81 | $309.03 | $501.19 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $524.81 | Professional | None | $199.53 | $316.23 | $524.81 |
7 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 $117.49 Median $134.90 Typical High $169.82 | Professional | 52 · Reduced service | $117.49 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $53.70 Typical High $67.61 | Professional | 53 · Discontinued | $46.77 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $199.53 Typical High $257.04 | Professional | 54 · Surgery only | $173.78 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $39.81 Typical High $51.29 | Professional | 55 · Aftercare only | $34.67 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $26.92 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.44 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $186.21 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $162.18 | $186.21 | $239.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $162.18 Typical High $257.04 | Professional | 51 · Multiple procedures | $134.90 | $162.18 | $257.04 |
Where South Carolina sits
The same service costs 3.7 times more in Wisconsin than in Utah. 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· 36th of 51
$309
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.