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 $295.12 Median $512.86 Typical High $10,000.00 | Facility | None | $295.12 | $512.86 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $407.38 Typical High $616.60 | Professional | None | $275.42 | $407.38 | $616.60 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $602.56 | Professional | None | $295.12 | $354.81 | $602.56 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $2,089.30 Typical High $9,549.93 | Facility | None | $691.83 | $2,089.30 | $9,549.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $501.19 | Professional | None | $208.93 | $338.84 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,122.02 Typical High $1,819.70 | Facility | None | $602.56 | $1,122.02 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $446.68 Typical High $660.69 | Professional | None | $257.04 | $446.68 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $295.12 Median $588.84 Typical High $1,202.26 | Facility | None | $295.12 | $588.84 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $707.95 | Professional | None | $380.19 | $549.54 | $707.95 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $346.74 Typical High $562.34 | Professional | None | $39.81 | $346.74 | $562.34 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $776.25 | Professional | None | $223.87 | $363.08 | $776.25 |
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 $138.04 Median $158.49 Typical High $213.80 | Professional | 52 · Reduced service | $138.04 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $64.57 Typical High $85.11 | Professional | 53 · Discontinued | $54.95 | $64.57 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $239.88 Typical High $323.59 | Professional | 54 · Surgery only | $208.93 | $239.88 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $47.86 Typical High $64.57 | Professional | 55 · Aftercare only | $41.69 | $47.86 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $31.62 Typical High $42.66 | Professional | 56 · Pre-op care only | $27.54 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $223.87 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $194.98 | $223.87 | $302.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $239.88 Median $275.42 Typical High $354.81 | Professional | 51 · Multiple procedures | $239.88 | $275.42 | $354.81 |
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· 34th of 51
$398
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.