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 $128.82 Median $4,897.79 Typical High $21,877.62 | Facility | None | $128.82 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $173.78 | Professional | None | $117.49 | $144.54 | $173.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $2,041.74 Typical High $3,548.13 | Facility | None | $1,202.26 | $2,041.74 | $3,548.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $158.49 | Professional | None | $97.72 | $141.25 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $251.19 Typical High $707.95 | Facility | None | $112.20 | $251.19 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $229.09 | Professional | None | $112.20 | $151.36 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $346.74 | Professional | None | $194.98 | $208.93 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $173.78 Typical High $218.78 | Facility | None | $114.82 | $173.78 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $186.21 | Professional | None | $138.04 | $177.83 | $186.21 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $223.87 | Professional | None | $97.72 | $141.25 | $223.87 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $229.09 | Professional | None | $97.72 | $141.25 | $229.09 |
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 $61.66 Median $70.79 Typical High $87.10 | Professional | 52 · Reduced service | $61.66 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $28.18 Typical High $34.67 | Professional | 53 · Discontinued | $24.55 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $107.15 Typical High $128.82 | Professional | 54 · Surgery only | $93.33 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.38 Typical High $25.70 | Professional | 55 · Aftercare only | $18.62 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.13 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.30 | $14.13 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $100.00 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $87.10 | $100.00 | $120.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $67.61 Median $93.33 Typical High $104.71 | Professional | 51 · Multiple procedures | $67.61 | $93.33 | $104.71 |
Where South Carolina sits
The same service costs 4.0 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· 34th of 51
$148
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.