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 $162.18 Median $4,897.79 Typical High $21,877.62 | Facility | None | $162.18 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $281.84 | Professional | None | $151.36 | $223.87 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
BCBS South Carolina Setting Facility Modifier None Typical Low $426.58 Median $741.31 Typical High $1,288.25 | Facility | None | $426.58 | $741.31 | $1,288.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $77.62 Median $128.82 Typical High $251.19 | Professional | None | $77.62 | $128.82 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $389.05 Typical High $707.95 | Facility | None | $223.87 | $389.05 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $323.59 | Professional | None | $138.04 | $213.80 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $562.34 | Professional | None | $281.84 | $295.12 | $562.34 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $281.84 Typical High $724.44 | Facility | None | $128.82 | $281.84 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $302.00 | Professional | None | $223.87 | $269.15 | $302.00 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $251.19 Typical High $416.87 | Professional | None | $37.15 | $251.19 | $416.87 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $123.03 Median $204.17 Typical High $323.59 | Professional | None | $123.03 | $204.17 | $323.59 |
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 $77.62 Median $109.65 Typical High $141.25 | Professional | 52 · Reduced service | $77.62 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $43.65 Typical High $56.23 | Professional | 53 · Discontinued | $30.90 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $165.96 Typical High $208.93 | Professional | 54 · Surgery only | $114.82 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $33.11 Typical High $41.69 | Professional | 55 · Aftercare only | $23.44 | $33.11 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $21.88 Typical High $28.18 | Professional | 56 · Pre-op care only | $15.49 | $21.88 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $154.88 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $107.15 | $154.88 | $194.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $109.65 Median $141.25 Typical High $169.82 | Professional | 51 · Multiple procedures | $109.65 | $141.25 | $169.82 |
Where South Carolina sits
The same service costs 3.5 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· 35th of 51
$219
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.