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 $223.87 Median $5,623.41 Typical High $21,877.62 | Facility | None | $223.87 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $257.04 | Professional | None | $204.17 | $223.87 | $257.04 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,778.28 Typical High $8,317.64 | Facility | None | $691.83 | $1,778.28 | $8,317.64 |
BCBS South Carolina Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $354.81 | Professional | None | $162.18 | $218.78 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,630.27 | Facility | None | $602.56 | $1,862.09 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $457.09 | Professional | None | $208.93 | $234.42 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $223.87 Median $588.84 Typical High $1,096.48 | Facility | None | $223.87 | $588.84 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $346.74 | Professional | None | $239.88 | $269.15 | $346.74 |
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 $181.97 Median $245.47 Typical High $446.68 | Professional | None | $181.97 | $245.47 | $446.68 |
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 $102.33 Median $112.20 Typical High $128.82 | Professional | 52 · Reduced service | $102.33 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $44.67 Typical High $51.29 | Professional | 53 · Discontinued | $40.74 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $169.82 Typical High $194.98 | Professional | 54 · Surgery only | $151.36 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.88 Typical High $38.90 | Professional | 55 · Aftercare only | $30.90 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.39 Typical High $25.70 | Professional | 56 · Pre-op care only | $20.42 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $158.49 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $141.25 | $158.49 | $181.97 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $123.03 Median $134.90 Typical High $204.17 | Professional | 51 · Multiple procedures | $123.03 | $134.90 | $204.17 |
Where South Carolina sits
The same service costs 5.9 times more in Oklahoma 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· 38th of 51
$251
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.