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 $316.23 Median $5,623.41 Typical High $21,877.62 | Facility | None | $316.23 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $426.58 | Professional | None | $295.12 | $354.81 | $426.58 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,513.56 Typical High $7,079.46 | Facility | None | $691.83 | $1,513.56 | $7,079.46 |
BCBS South Carolina Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $346.74 | Professional | None | $234.42 | $331.13 | $346.74 |
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 $288.40 Median $354.81 Typical High $524.81 | Professional | None | $288.40 | $354.81 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $870.96 | Professional | None | $426.58 | $457.09 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $588.84 Typical High $1,258.93 | Facility | None | $275.42 | $588.84 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $436.52 | Professional | None | $338.84 | $416.87 | $436.52 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $323.59 Typical High $549.54 | Professional | None | $33.88 | $323.59 | $549.54 |
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 $245.47 Median $346.74 Typical High $549.54 | Professional | None | $245.47 | $346.74 | $549.54 |
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 $151.36 Median $173.78 Typical High $213.80 | Professional | 52 · Reduced service | $151.36 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $69.18 Typical High $85.11 | Professional | 53 · Discontinued | $60.26 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $263.03 Typical High $323.59 | Professional | 54 · Surgery only | $229.09 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $52.48 Typical High $64.57 | Professional | 55 · Aftercare only | $45.71 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $34.67 Typical High $42.66 | Professional | 56 · Pre-op care only | $30.20 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $245.47 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $213.80 | $245.47 | $302.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $213.80 Typical High $257.04 | Professional | 51 · Multiple procedures | $169.82 | $213.80 | $257.04 |
Where South Carolina sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 38th of 51
$339
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.