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 $1,023.29 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,023.29 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,023.29 | Professional | None | $812.83 | $1,023.29 | $1,023.29 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,715.35 Typical High $12,882.50 | Facility | None | $851.14 | $3,715.35 | $12,882.50 |
BCBS South Carolina Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $1,659.59 | Professional | None | $724.44 | $1,122.02 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $4,168.69 | Facility | None | $602.56 | $2,398.83 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $954.99 Typical High $1,819.70 | Professional | None | $933.25 | $954.99 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $1,000.00 Typical High $2,290.87 | Facility | None | $630.96 | $1,000.00 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,548.82 | Professional | None | $954.99 | $1,096.48 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $758.58 Typical High $1,288.25 | Professional | None | $66.07 | $758.58 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,737.80 | Professional | None | $794.33 | $1,000.00 | $1,737.80 |
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 $407.38 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $407.38 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $165.96 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $616.60 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $123.03 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $81.28 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $575.44 | $724.44 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $549.54 Typical High $794.33 | Professional | 51 · Multiple procedures | $512.86 | $549.54 | $794.33 |
Where South Carolina sits
The same service costs 5.9 times more in Alaska than in Texas. 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
$955
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.