How much rates vary
Facilitymedian $2,042 · 10th to 90th $501 to $10,471Professionalmedian $339 · 10th to 90th $195 to $603
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 $257.04 Median $5,623.41 Typical High $21,877.62 | Facility | None | $257.04 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $380.19 | Professional | None | $218.78 | $257.04 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $389.05 | Professional | None | $107.15 | $107.15 | $389.05 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,862.09 Typical High $9,549.93 | Facility | None | $512.86 | $1,862.09 | $9,549.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $194.98 Median $537.03 Typical High $602.56 | Professional | None | $194.98 | $537.03 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,737.80 Typical High $2,511.89 | Facility | None | $457.09 | $1,737.80 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $512.86 | Professional | None | $257.04 | $389.05 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $645.65 | Professional | None | $512.86 | $512.86 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $346.74 Median $2,187.76 Typical High $2,754.23 | Facility | None | $346.74 | $2,187.76 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $467.74 Typical High $549.54 | Professional | None | $251.19 | $467.74 | $549.54 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $380.19 | Professional | None | $186.21 | $245.47 | $380.19 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $616.60 | Professional | None | $190.55 | $295.12 | $616.60 |
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 $109.65 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $109.65 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $43.65 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $194.98 Typical High $194.98 | Professional | 54 · Surgery only | $162.18 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $33.11 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $21.88 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $181.97 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $151.36 | $181.97 | $181.97 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $239.88 Typical High $281.84 | Professional | 51 · Multiple procedures | $158.49 | $239.88 | $281.84 |
Where South Carolina sits
The same service costs 4.6 times more in Alaska 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· 21st of 51
$389
AK $891UT $195
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.