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 $204.17 Median $4,897.79 Typical High $21,877.62 | Facility | None | $204.17 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $269.15 | Professional | None | $181.97 | $208.93 | $269.15 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,819.70 Typical High $8,128.31 | Facility | None | $512.86 | $1,819.70 | $8,128.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $158.49 Median $302.00 Typical High $407.38 | Professional | None | $158.49 | $302.00 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,479.11 Typical High $2,691.53 | Facility | None | $457.09 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $457.09 | Professional | None | $186.21 | $223.87 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $177.83 Median $436.52 Typical High $1,047.13 | Facility | None | $177.83 | $436.52 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $354.81 | Professional | None | $234.42 | $269.15 | $354.81 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $398.11 | Professional | None | $181.97 | $269.15 | $398.11 |
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 $173.78 Median $234.42 Typical High $407.38 | Professional | None | $173.78 | $234.42 | $407.38 |
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 $95.50 Median $102.33 Typical High $134.90 | Professional | 52 · Reduced service | $95.50 | $102.33 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $40.74 Typical High $53.70 | Professional | 53 · Discontinued | $38.02 | $40.74 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $154.88 Typical High $204.17 | Professional | 54 · Surgery only | $144.54 | $154.88 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.90 Typical High $40.74 | Professional | 55 · Aftercare only | $28.84 | $30.90 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $20.42 Typical High $26.92 | Professional | 56 · Pre-op care only | $19.05 | $20.42 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $144.54 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $134.90 | $144.54 | $190.55 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $117.49 Median $134.90 Typical High $204.17 | Professional | 51 · Multiple procedures | $117.49 | $134.90 | $204.17 |
Where South Carolina sits
The same service costs 4.4 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· 25th of 51
$302
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.