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 $75.86 Median $4,897.79 Typical High $21,877.62 | Facility | None | $75.86 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $128.82 Typical High $199.53 | Professional | None | $70.79 | $128.82 | $199.53 |
BCBS South Carolina Setting Facility Modifier None Typical Low $870.96 Median $1,479.11 Typical High $2,630.27 | Facility | None | $870.96 | $1,479.11 | $2,630.27 |
BCBS South Carolina Setting Professional Modifier None Typical Low $58.88 Median $169.82 Typical High $190.55 | Professional | None | $58.88 | $169.82 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $363.08 Typical High $1,318.26 | Facility | None | $165.96 | $363.08 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $134.90 Typical High $204.17 | Professional | None | $74.13 | $134.90 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $398.11 | Professional | None | $234.42 | $251.19 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $199.53 Typical High $724.44 | Facility | None | $83.18 | $199.53 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $223.87 | Professional | None | $147.91 | $190.55 | $223.87 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $302.00 | Professional | None | $154.88 | $199.53 | $302.00 |
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 $60.26 Median $131.83 Typical High $234.42 | Professional | None | $60.26 | $131.83 | $234.42 |
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 $36.31 Median $60.26 Typical High $100.00 | Professional | 52 · Reduced service | $36.31 | $60.26 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $23.99 Typical High $39.81 | Professional | 53 · Discontinued | $14.45 | $23.99 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $89.13 Typical High $147.91 | Professional | 54 · Surgery only | $54.95 | $89.13 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $17.78 Typical High $29.51 | Professional | 55 · Aftercare only | $10.96 | $17.78 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $12.02 Typical High $19.95 | Professional | 56 · Pre-op care only | $7.24 | $12.02 | $19.95 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 78 · Unplanned return to OR | $64.57 | $64.57 | $64.57 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $112.20 Typical High $120.23 | Professional | 51 · Multiple procedures | $74.13 | $112.20 | $120.23 |
Where South Carolina sits
The same service costs 3.7 times more in Alaska than in Washington, DC. 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· 17th of 51
$162
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.