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 $512.86 Median $9,120.11 Typical High $22,908.68 | Facility | None | $512.86 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $512.86 | Professional | None | $426.58 | $512.86 | $512.86 |
BCBS South Carolina Setting Facility Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Facility | None | $5,754.40 | $5,754.40 | $5,754.40 |
BCBS South Carolina Setting Professional Modifier None Typical Low $162.18 Median $389.05 Typical High $407.38 | Professional | None | $162.18 | $389.05 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $707.95 | Professional | None | $446.68 | $446.68 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $1,000.00 | Professional | None | $512.86 | $549.54 | $1,000.00 |
Medcost Setting Facility Modifier None Typical Low $338.84 Median $724.44 Typical High $724.44 | Facility | None | $338.84 | $724.44 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $501.19 Typical High $616.60 | Professional | None | $245.47 | $501.19 | $616.60 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $436.52 Typical High $691.83 | Professional | None | $58.88 | $436.52 | $691.83 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,288.25 Typical High $8,511.38 | Facility | None | $512.86 | $1,288.25 | $8,511.38 |
United Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $758.58 | Professional | None | $363.08 | $446.68 | $758.58 |
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 $213.80 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $213.80 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $85.11 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $316.23 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $63.10 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $42.66 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $295.12 | $354.81 | $354.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $123.03 Median $263.03 Typical High $309.03 | Professional | 51 · Multiple procedures | $123.03 | $263.03 | $309.03 |
Where South Carolina sits
The same service costs 5.5 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· 41st of 51
$447
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.