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 $389.05 Median $5,623.41 Typical High $21,877.62 | Facility | None | $389.05 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $537.03 | Professional | None | $363.08 | $446.68 | $537.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $2,344.23 Typical High $10,232.93 | Facility | None | $691.83 | $2,344.23 | $10,232.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $478.63 | Professional | None | $288.40 | $436.52 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $4,677.35 | Facility | None | $602.56 | $1,995.26 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $660.69 | Professional | None | $354.81 | $457.09 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $1,122.02 | Professional | None | $575.44 | $616.60 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $602.56 Typical High $1,995.26 | Facility | None | $371.54 | $602.56 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $676.08 | Professional | None | $426.58 | $537.03 | $676.08 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $446.68 Typical High $741.31 | Professional | None | $37.15 | $446.68 | $741.31 |
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 $309.03 Median $446.68 Typical High $691.83 | Professional | None | $309.03 | $446.68 | $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 $190.55 Median $218.78 Typical High $269.15 | Professional | 52 · Reduced service | $190.55 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $87.10 Typical High $107.15 | Professional | 53 · Discontinued | $75.86 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $323.59 Typical High $398.11 | Professional | 54 · Surgery only | $288.40 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $66.07 Typical High $79.43 | Professional | 55 · Aftercare only | $57.54 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $43.65 Typical High $53.70 | Professional | 56 · Pre-op care only | $38.02 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $302.00 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $269.15 | $302.00 | $371.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $208.93 Median $275.42 Typical High $416.87 | Professional | 51 · Multiple procedures | $208.93 | $275.42 | $416.87 |
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· 36th of 51
$447
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.