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 $338.84 Median $5,623.41 Typical High $21,877.62 | Facility | None | $338.84 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $436.52 | Professional | None | $331.13 | $363.08 | $436.52 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,479.11 Typical High $7,079.46 | Facility | None | $691.83 | $1,479.11 | $7,079.46 |
BCBS South Carolina Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $467.74 | Professional | None | $251.19 | $338.84 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $2,290.87 | Facility | None | $602.56 | $1,621.81 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $724.44 | Professional | None | $309.03 | $380.19 | $724.44 |
Medcost Setting Facility Modifier None Typical Low $288.40 Median $588.84 Typical High $1,288.25 | Facility | None | $288.40 | $588.84 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $549.54 | Professional | None | $371.54 | $426.58 | $549.54 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $380.19 Typical High $630.96 | Professional | None | $39.81 | $380.19 | $630.96 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $691.83 | Professional | None | $281.84 | $407.38 | $691.83 |
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 $165.96 Median $173.78 Typical High $218.78 | Professional | 52 · Reduced service | $165.96 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $69.18 Typical High $87.10 | Professional | 53 · Discontinued | $67.61 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $257.04 Typical High $331.13 | Professional | 54 · Surgery only | $251.19 | $257.04 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $51.29 Typical High $66.07 | Professional | 55 · Aftercare only | $50.12 | $51.29 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $34.67 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.88 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $239.88 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $234.42 | $239.88 | $309.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $213.80 Typical High $331.13 | Professional | 51 · Multiple procedures | $194.98 | $213.80 | $331.13 |
Where South Carolina sits
The same service costs 4.9 times more in Alaska 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· 40th of 51
$407
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.