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 $218.78 Median $4,897.79 Typical High $21,877.62 | Facility | None | $218.78 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $281.84 | Professional | None | $190.55 | $218.78 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,202.26 Typical High $8,511.38 | Facility | None | $512.86 | $1,202.26 | $8,511.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $331.13 | Professional | None | $144.54 | $251.19 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,230.27 Typical High $1,737.80 | Facility | None | $457.09 | $1,230.27 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $446.68 | Professional | None | $173.78 | $234.42 | $446.68 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $457.09 Typical High $1,000.00 | Facility | None | $218.78 | $457.09 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $346.74 | Professional | None | $181.97 | $263.03 | $346.74 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $371.54 | Professional | None | $169.82 | $251.19 | $371.54 |
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 $165.96 Median $234.42 Typical High $389.05 | Professional | None | $165.96 | $234.42 | $389.05 |
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 $100.00 Median $109.65 Typical High $141.25 | Professional | 52 · Reduced service | $100.00 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $43.65 Typical High $56.23 | Professional | 53 · Discontinued | $40.74 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $165.96 Typical High $213.80 | Professional | 54 · Surgery only | $151.36 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $33.11 Typical High $42.66 | Professional | 55 · Aftercare only | $30.20 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $21.88 Typical High $28.18 | Professional | 56 · Pre-op care only | $20.42 | $21.88 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $154.88 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $141.25 | $154.88 | $199.53 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $91.20 Median $134.90 Typical High $194.98 | Professional | 51 · Multiple procedures | $91.20 | $134.90 | $194.98 |
Where South Carolina sits
The same service costs 4.6 times more in Alaska 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· 31st of 51
$269
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.