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 $194.98 Median $4,897.79 Typical High $21,877.62 | Facility | None | $194.98 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $302.00 | Professional | None | $194.98 | $257.04 | $302.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,691.53 Median $4,677.35 Typical High $7,943.28 | Facility | None | $2,691.53 | $4,677.35 | $7,943.28 |
BCBS South Carolina Setting Professional Modifier None Typical Low $93.33 Median $147.91 Typical High $234.42 | Professional | None | $93.33 | $147.91 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $707.95 | Facility | None | $229.09 | $398.11 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $467.74 | Professional | None | $169.82 | $251.19 | $467.74 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $316.23 Typical High $724.44 | Facility | None | $141.25 | $316.23 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $338.84 | Professional | None | $204.17 | $275.42 | $338.84 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $229.09 Typical High $398.11 | Professional | None | $37.15 | $229.09 | $398.11 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $158.49 Median $257.04 Typical High $426.58 | Professional | None | $158.49 | $257.04 | $426.58 |
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 $97.72 Median $117.49 Typical High $151.36 | Professional | 52 · Reduced service | $97.72 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $47.86 Typical High $60.26 | Professional | 53 · Discontinued | $38.90 | $47.86 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $177.83 Typical High $223.87 | Professional | 54 · Surgery only | $144.54 | $177.83 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $35.48 Typical High $45.71 | Professional | 55 · Aftercare only | $28.84 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $23.99 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.50 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $165.96 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $134.90 | $165.96 | $208.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $138.04 Typical High $223.87 | Professional | 51 · Multiple procedures | $102.33 | $138.04 | $223.87 |
Where South Carolina sits
The same service costs 4.3 times more in Wisconsin 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· 47th of 51
$234
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.