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 $141.25 Median $181.97 Typical High $21,877.62 | Facility | None | $141.25 | $181.97 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $181.97 | Professional | None | $125.89 | $141.25 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
BCBS South Carolina Setting Facility Modifier None Typical Low $134.90 Median $223.87 Typical High $416.87 | Facility | None | $134.90 | $223.87 | $416.87 |
BCBS South Carolina Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $169.82 | Professional | None | $91.20 | $100.00 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $794.33 | Facility | None | $52.48 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $288.40 | Professional | None | $112.20 | $141.25 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $93.33 Typical High $204.17 | Facility | None | $43.65 | $93.33 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $199.53 | Professional | None | $134.90 | $162.18 | $199.53 |
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 $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $245.47 | Professional | None | $104.71 | $144.54 | $245.47 |
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 $64.57 Median $70.79 Typical High $91.20 | Professional | 52 · Reduced service | $64.57 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $28.18 Typical High $36.31 | Professional | 53 · Discontinued | $25.70 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $107.15 Typical High $138.04 | Professional | 54 · Surgery only | $97.72 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $21.38 Typical High $27.54 | Professional | 55 · Aftercare only | $19.50 | $21.38 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $14.13 Typical High $18.20 | Professional | 56 · Pre-op care only | $12.88 | $14.13 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $100.00 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $91.20 | $100.00 | $128.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $85.11 Typical High $125.89 | Professional | 51 · Multiple procedures | $72.44 | $85.11 | $125.89 |
Where South Carolina sits
The same service costs 4.1 times more in Alaska 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· 35th of 51
$151
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.