How much rates vary
Facilitymedian $2,239 · 10th to 90th $331 to $6,026Professionalmedian $229 · 10th to 90th $100 to $468
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 $218.78 Median $363.08 Typical High $21,877.62 | Facility | None | $218.78 | $363.08 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $363.08 | Professional | None | $186.21 | $234.42 | $363.08 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,737.80 Median $3,090.30 Typical High $6,165.95 | Facility | None | $1,737.80 | $3,090.30 | $6,165.95 |
BCBS South Carolina Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $331.13 | Professional | None | $100.00 | $181.97 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $549.54 Typical High $1,318.26 | Facility | None | $331.13 | $549.54 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $380.19 | Professional | None | $123.03 | $190.55 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $239.88 Typical High $758.58 | Professional | None | $234.42 | $239.88 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $363.08 Typical High $724.44 | Facility | None | $154.88 | $363.08 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $245.47 Typical High $354.81 | Professional | None | $79.43 | $245.47 | $354.81 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $338.84 Typical High $575.44 | Professional | None | $37.15 | $338.84 | $575.44 |
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 $138.04 Median $208.93 Typical High $354.81 | Professional | None | $138.04 | $208.93 | $354.81 |
8 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 $100.00 Median $114.82 Typical High $181.97 | Professional | 52 · Reduced service | $100.00 | $114.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $45.71 Typical High $74.13 | Professional | 53 · Discontinued | $39.81 | $45.71 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $173.78 Typical High $275.42 | Professional | 54 · Surgery only | $151.36 | $173.78 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $34.67 Typical High $54.95 | Professional | 55 · Aftercare only | $30.20 | $34.67 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $22.91 Typical High $36.31 | Professional | 56 · Pre-op care only | $19.95 | $22.91 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $162.18 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $141.25 | $162.18 | $257.04 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 51 · Multiple procedures | $169.82 | $169.82 | $169.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $39.81 Median $123.03 Typical High $223.87 | Professional | 51 · Multiple procedures | $39.81 | $123.03 | $223.87 |
Where South Carolina sits
The same service costs 4.5 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· 39th of 51
$240
AK $741KY $166
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.