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 $2,951.21 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,951.21 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,290.87 | $2,951.21 | $2,951.21 |
BCBS South Carolina Setting Facility Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Facility | None | $6,025.60 | $6,025.60 | $6,025.60 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,513.56 | $1,513.56 | $1,584.89 |
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 $1,949.84 Median $2,570.40 Typical High $6,165.95 | Professional | None | $1,949.84 | $2,570.40 | $6,165.95 |
Medcost Setting Facility Modifier None Typical Low $2,951.21 Median $3,311.31 Typical High $3,981.07 | Facility | None | $2,951.21 | $3,311.31 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,090.30 | Professional | None | $3,019.95 | $3,019.95 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $3,548.13 | Professional | None | $1,737.80 | $2,238.72 | $3,548.13 |
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 $1,148.15 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,148.15 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $467.74 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,737.80 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $346.74 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $229.09 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,621.81 | $2,089.30 | $2,089.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,479.11 Median $1,479.11 Typical High $1,905.46 | Professional | 51 · Multiple procedures | $1,479.11 | $1,479.11 | $1,905.46 |
Where South Carolina sits
The same service costs 18.2 times more in Alaska than in New York. 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· 32nd of 51
$2,455
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.