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 $489.78 Median $5,623.41 Typical High $21,877.62 | Facility | None | $489.78 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $489.78 | Professional | None | $407.38 | $489.78 | $489.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $177.83 Median $302.00 Typical High $524.81 | Facility | None | $177.83 | $302.00 | $524.81 |
BCBS South Carolina Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $416.87 | Professional | None | $309.03 | $346.74 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $147.91 Typical High $234.42 | Facility | None | $75.86 | $147.91 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $660.69 | Professional | None | $407.38 | $426.58 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $977.24 | Professional | None | $501.19 | $537.03 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $47.86 Median $537.03 Typical High $724.44 | Facility | None | $47.86 | $537.03 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $501.19 | Professional | None | $389.05 | $478.63 | $501.19 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $398.11 Typical High $630.96 | Professional | None | $43.65 | $398.11 | $630.96 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $707.95 | Professional | None | $338.84 | $416.87 | $707.95 |
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 $199.53 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $199.53 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $81.28 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $302.00 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $60.26 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $40.74 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $338.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $281.84 | $338.84 | $338.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $245.47 Typical High $295.12 | Professional | 51 · Multiple procedures | $194.98 | $245.47 | $295.12 |
Where South Carolina sits
The same service costs 4.2 times more in Wyoming 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
$417
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.