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 $467.74 Median $5,623.41 Typical High $21,877.62 | Facility | None | $467.74 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $1,258.93 Typical High $1,659.59 | Professional | None | $467.74 | $1,258.93 | $1,659.59 |
BCBS South Carolina Setting Facility Modifier None Typical Low $7,244.36 Median $12,589.25 Typical High $21,379.62 | Facility | None | $7,244.36 | $12,589.25 | $21,379.62 |
BCBS South Carolina Setting Professional Modifier None Typical Low $338.84 Median $758.58 Typical High $2,951.21 | Professional | None | $338.84 | $758.58 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $2,137.96 | Facility | None | $602.56 | $1,318.26 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $1,380.38 Typical High $3,388.44 | Professional | None | $512.86 | $1,380.38 | $3,388.44 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $1,949.84 Typical High $3,019.95 | Facility | None | $537.03 | $1,949.84 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $2,951.21 Typical High $4,786.30 | Professional | None | $1,445.44 | $2,951.21 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $1,288.25 Typical High $2,344.23 | Professional | None | $125.89 | $1,288.25 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $21,379.62 | Facility | None | $1,445.44 | $4,265.80 | $21,379.62 |
United Setting Professional Modifier None Typical Low $371.54 Median $1,202.26 Typical High $4,168.69 | Professional | None | $371.54 | $1,202.26 | $4,168.69 |
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 $234.42 Median $338.84 Typical High $831.76 | Professional | 52 · Reduced service | $234.42 | $338.84 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $134.90 Typical High $331.13 | Professional | 53 · Discontinued | $93.33 | $134.90 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $501.19 Typical High $1,230.27 | Professional | 54 · Surgery only | $346.74 | $501.19 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $100.00 Typical High $251.19 | Professional | 55 · Aftercare only | $69.18 | $100.00 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $67.61 Typical High $165.96 | Professional | 56 · Pre-op care only | $46.77 | $67.61 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $467.74 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $323.59 | $467.74 | $1,148.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $954.99 Median $1,479.11 Typical High $2,398.83 | Professional | 51 · Multiple procedures | $954.99 | $1,479.11 | $2,398.83 |
Where South Carolina sits
The same service costs 4.9 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· 37th of 51
$1,318
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.