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 $1,230.27 Median $5,888.44 Typical High $21,877.62 | Facility | None | $1,230.27 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,000.00 | $1,230.27 | $1,230.27 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,023.29 Median $3,388.44 Typical High $10,471.29 | Facility | None | $1,023.29 | $3,388.44 | $10,471.29 |
BCBS South Carolina Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,698.24 | Professional | None | $891.25 | $1,023.29 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,122.02 Typical High $1,905.46 | Facility | None | $602.56 | $1,122.02 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $2,187.76 | Professional | None | $1,122.02 | $1,148.15 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $851.14 Median $1,230.27 Typical High $2,754.23 | Facility | None | $851.14 | $1,230.27 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $1,479.11 | Professional | None | $1,148.15 | $1,230.27 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $870.96 Typical High $1,584.89 | Professional | None | $85.11 | $870.96 | $1,584.89 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $2,089.30 | Professional | None | $954.99 | $1,258.93 | $2,089.30 |
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 $489.78 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $489.78 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $199.53 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $741.31 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $147.91 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $100.00 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $691.83 | $870.96 | $870.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $660.69 Typical High $891.25 | Professional | 51 · Multiple procedures | $575.44 | $660.69 | $891.25 |
Where South Carolina sits
The same service costs 5.9 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· 45th of 51
$1,047
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.