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 $549.54 Median $5,888.44 Typical High $21,877.62 | Facility | None | $549.54 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $549.54 | Professional | None | $489.78 | $549.54 | $549.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,819.70 Typical High $8,128.31 | Facility | None | $691.83 | $1,819.70 | $8,128.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $562.34 | Professional | None | $371.54 | $489.78 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,454.71 Typical High $3,548.13 | Facility | None | $602.56 | $2,454.71 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $1,000.00 | Professional | None | $489.78 | $524.81 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $489.78 Median $676.08 Typical High $1,479.11 | Facility | None | $489.78 | $676.08 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $660.69 | Professional | None | $467.74 | $588.84 | $660.69 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $398.11 Typical High $676.08 | Professional | None | $79.43 | $398.11 | $676.08 |
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 $436.52 Median $549.54 Typical High $977.24 | Professional | None | $436.52 | $549.54 | $977.24 |
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 $239.88 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $97.72 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $363.08 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $48.98 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $338.84 | $380.19 | $380.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $295.12 Typical High $416.87 | Professional | 51 · Multiple procedures | $234.42 | $295.12 | $416.87 |
Where South Carolina sits
The same service costs 6.5 times more in Alaska 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· 45th of 51
$490
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.