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 $5,623.41 Typical High $21,877.62 | Facility | None | $123.03 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $181.97 | Professional | None | $117.49 | $144.54 | $181.97 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,090.30 Median $5,128.61 Typical High $9,332.54 | Facility | None | $3,090.30 | $5,128.61 | $9,332.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $208.93 | Professional | None | $97.72 | $151.36 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $223.87 Typical High $1,318.26 | Facility | None | $102.33 | $223.87 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $288.40 | Professional | None | $125.89 | $151.36 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $74.13 Median $109.65 Typical High $204.17 | Facility | None | $74.13 | $109.65 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $223.87 | Professional | None | $154.88 | $186.21 | $223.87 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $281.84 | Professional | None | $112.20 | $177.83 | $281.84 |
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 $112.20 Median $158.49 Typical High $281.84 | Professional | None | $112.20 | $158.49 | $281.84 |
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 $60.26 Median $66.07 Typical High $91.20 | Professional | 52 · Reduced service | $60.26 | $66.07 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $26.30 Typical High $37.15 | Professional | 53 · Discontinued | $23.99 | $26.30 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $100.00 Typical High $138.04 | Professional | 54 · Surgery only | $91.20 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.95 Typical High $27.54 | Professional | 55 · Aftercare only | $18.20 | $19.95 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.18 Typical High $18.20 | Professional | 56 · Pre-op care only | $12.02 | $13.18 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $93.33 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $85.11 | $93.33 | $128.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $81.28 Median $95.50 Typical High $138.04 | Professional | 51 · Multiple procedures | $81.28 | $95.50 | $138.04 |
Where South Carolina sits
The same service costs 3.6 times more in Wisconsin than in Texas. 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· 32nd of 51
$174
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.