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 $977.24 Median $15,135.61 Typical High $24,547.09 | Facility | None | $977.24 | $15,135.61 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,071.52 | Professional | None | $741.31 | $977.24 | $1,071.52 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,467.37 Median $7,079.46 Typical High $29,512.09 | Facility | None | $3,467.37 | $7,079.46 | $29,512.09 |
BCBS South Carolina Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,412.54 | Professional | None | $660.69 | $912.01 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,311.31 Typical High $4,677.35 | Facility | None | $630.96 | $3,311.31 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $1,659.59 | Professional | None | $851.14 | $870.96 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $3,630.78 Typical High $4,897.79 | Facility | None | $912.01 | $3,630.78 | $4,897.79 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,122.02 | Professional | None | $812.83 | $1,000.00 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $724.44 Typical High $1,202.26 | Professional | None | $81.28 | $724.44 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,548.82 | Professional | None | $724.44 | $891.25 | $1,548.82 |
8 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 $371.54 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $371.54 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $147.91 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $549.54 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $109.65 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $74.13 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $512.86 | $676.08 | $676.08 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,513.56 Typical High $2,137.96 | Professional | 50 · Both sides | $1,230.27 | $1,513.56 | $2,137.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $501.19 Typical High $676.08 | Professional | 51 · Multiple procedures | $407.38 | $501.19 | $676.08 |
Where South Carolina sits
The same service costs 7.2 times more in Oklahoma 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· 40th of 51
$912
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.