How much rates vary
Facilitymedian $1,148 · 10th to 90th $282 to $3,981Professionalmedian $234 · 10th to 90th $110 to $407
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 $229.09 Median $363.08 Typical High $10,000.00 | Facility | None | $229.09 | $363.08 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $338.84 | Professional | None | $199.53 | $245.47 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $380.19 | Professional | None | $186.21 | $275.42 | $380.19 |
BCBS South Carolina Setting Facility Modifier None Typical Low $831.76 Median $1,445.44 Typical High $2,454.71 | Facility | None | $831.76 | $1,445.44 | $2,454.71 |
BCBS South Carolina Setting Professional Modifier None Typical Low $109.65 Median $186.21 Typical High $309.03 | Professional | None | $109.65 | $186.21 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $724.44 | Facility | None | $269.15 | $426.58 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $407.38 | Professional | None | $177.83 | $234.42 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $676.08 | Professional | None | $199.53 | $213.80 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $131.83 Median $331.13 Typical High $724.44 | Facility | None | $131.83 | $331.13 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $323.59 | Professional | None | $194.98 | $295.12 | $323.59 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $288.40 Typical High $489.78 | Professional | None | $33.88 | $288.40 | $489.78 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,165.95 | Facility | None | $302.00 | $1,122.02 | $6,165.95 |
United Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $380.19 | Professional | None | $169.82 | $245.47 | $380.19 |
9 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 $109.65 Median $131.83 Typical High $165.96 | Professional | 52 · Reduced service | $109.65 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $52.48 Typical High $66.07 | Professional | 53 · Discontinued | $43.65 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $194.98 Typical High $251.19 | Professional | 54 · Surgery only | $162.18 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $38.90 Typical High $50.12 | Professional | 55 · Aftercare only | $33.11 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $26.30 Typical High $33.11 | Professional | 56 · Pre-op care only | $21.88 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $181.97 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $151.36 | $181.97 | $234.42 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | GC · Resident with teaching physician | $562.34 | $562.34 | $562.34 |
Ambetter Setting Professional Modifier XS · Separate structure Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | XS · Separate structure | $169.82 | $169.82 | $169.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $147.91 Typical High $199.53 | Professional | 51 · Multiple procedures | $95.50 | $147.91 | $199.53 |
Where South Carolina sits
The same service costs 3.8 times more in Alaska 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· 40th of 51
$234
AK $776KY $204
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.