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 $123.03 Median $173.78 Typical High $21,877.62 | Facility | None | $123.03 | $173.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $173.78 | Professional | None | $104.71 | $128.82 | $173.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,235.94 Median $5,495.41 Typical High $9,772.37 | Facility | None | $3,235.94 | $5,495.41 | $9,772.37 |
BCBS South Carolina Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $151.36 | Professional | None | $83.18 | $114.82 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $234.42 Typical High $1,318.26 | Facility | None | $107.15 | $234.42 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $257.04 | Professional | None | $97.72 | $128.82 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $79.43 Median $123.03 Typical High $190.55 | Facility | None | $79.43 | $123.03 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $263.03 | Professional | None | $120.23 | $151.36 | $263.03 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $239.88 | Professional | None | $104.71 | $158.49 | $239.88 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $218.78 | Professional | None | $91.20 | $128.82 | $218.78 |
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 $56.23 Median $61.66 Typical High $87.10 | Professional | 52 · Reduced service | $56.23 | $61.66 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $25.12 Typical High $34.67 | Professional | 53 · Discontinued | $22.91 | $25.12 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $93.33 Typical High $131.83 | Professional | 54 · Surgery only | $85.11 | $93.33 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $18.62 Typical High $26.30 | Professional | 55 · Aftercare only | $16.98 | $18.62 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.30 Typical High $17.38 | Professional | 56 · Pre-op care only | $11.22 | $12.30 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $87.10 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $79.43 | $87.10 | $123.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $60.26 Median $74.13 Typical High $131.83 | Professional | 51 · Multiple procedures | $60.26 | $74.13 | $131.83 |
Where South Carolina sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 31st of 51
$148
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.