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 $204.17 Median $4,897.79 Typical High $21,877.62 | Facility | None | $204.17 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $229.09 | Professional | None | $186.21 | $204.17 | $229.09 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,162.28 Median $5,370.32 Typical High $9,332.54 | Facility | None | $3,162.28 | $5,370.32 | $9,332.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $269.15 | Professional | None | $144.54 | $190.55 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $218.78 Typical High $1,318.26 | Facility | None | $100.00 | $218.78 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $416.87 | Professional | None | $177.83 | $204.17 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $134.90 Typical High $275.42 | Facility | None | $87.10 | $134.90 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $295.12 | Professional | None | $186.21 | $234.42 | $295.12 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $371.54 | Professional | None | $138.04 | $229.09 | $371.54 |
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 $162.18 Median $218.78 Typical High $389.05 | Professional | None | $162.18 | $218.78 | $389.05 |
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 $91.20 Median $102.33 Typical High $114.82 | Professional | 52 · Reduced service | $91.20 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $40.74 Typical High $46.77 | Professional | 53 · Discontinued | $37.15 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $151.36 Typical High $173.78 | Professional | 54 · Surgery only | $138.04 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.20 Typical High $34.67 | Professional | 55 · Aftercare only | $27.54 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $20.42 Typical High $22.91 | Professional | 56 · Pre-op care only | $18.62 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $141.25 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $128.82 | $141.25 | $162.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $117.49 Typical High $169.82 | Professional | 51 · Multiple procedures | $102.33 | $117.49 | $169.82 |
Where South Carolina sits
The same service costs 4.9 times more in Oklahoma than in Florida. 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
$229
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.