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 $3,801.89 Typical High $16,595.87 | Facility | None | $123.03 | $3,801.89 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $218.78 | Professional | None | $109.65 | $144.54 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $316.23 | Professional | None | $158.49 | $158.49 | $316.23 |
BCBS South Carolina Setting Facility Modifier None Typical Low $269.15 Median $645.65 Typical High $891.25 | Facility | None | $269.15 | $645.65 | $891.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $181.97 | Professional | None | $95.50 | $120.23 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $275.42 Typical High $707.95 | Facility | None | $125.89 | $275.42 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $288.40 | Professional | None | $102.33 | $144.54 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $85.11 Median $112.20 Typical High $223.87 | Facility | None | $85.11 | $112.20 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $245.47 | Professional | None | $151.36 | $173.78 | $245.47 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $302.00 | Professional | None | $134.90 | $204.17 | $302.00 |
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 $97.72 Median $147.91 Typical High $251.19 | Professional | None | $97.72 | $147.91 | $251.19 |
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 $57.54 Median $64.57 Typical High $102.33 | Professional | 52 · Reduced service | $57.54 | $64.57 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $26.30 Typical High $40.74 | Professional | 53 · Discontinued | $22.91 | $26.30 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $97.72 Typical High $151.36 | Professional | 54 · Surgery only | $87.10 | $97.72 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.50 Typical High $30.20 | Professional | 55 · Aftercare only | $17.38 | $19.50 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.18 Typical High $20.42 | Professional | 56 · Pre-op care only | $11.48 | $13.18 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $91.20 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $81.28 | $91.20 | $141.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $75.86 Median $93.33 Typical High $131.83 | Professional | 51 · Multiple procedures | $75.86 | $93.33 | $131.83 |
Where South Carolina sits
The same service costs 3.6 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· 27th of 51
$178
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.