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 $186.21 Median $4,897.79 Typical High $21,877.62 | Facility | None | $186.21 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $281.84 | Professional | None | $186.21 | $208.93 | $281.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $501.19 Median $870.96 Typical High $3,019.95 | Facility | None | $501.19 | $870.96 | $3,019.95 |
BCBS South Carolina Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $275.42 | Professional | None | $131.83 | $190.55 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $562.34 Typical High $891.25 | Facility | None | $457.09 | $562.34 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $309.03 Typical High $407.38 | Professional | None | $165.96 | $309.03 | $407.38 |
Medcost Setting Facility Modifier None Typical Low $186.21 Median $436.52 Typical High $645.65 | Facility | None | $186.21 | $436.52 | $645.65 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $478.63 | Professional | None | $257.04 | $346.74 | $478.63 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $407.38 | Professional | None | $204.17 | $281.84 | $407.38 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,025.60 | Facility | None | $302.00 | $1,122.02 | $6,025.60 |
United Setting Professional Modifier None Typical Low $134.90 Median $213.80 Typical High $416.87 | Professional | None | $134.90 | $213.80 | $416.87 |
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 $93.33 Median $102.33 Typical High $141.25 | Professional | 52 · Reduced service | $93.33 | $102.33 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $41.69 Typical High $56.23 | Professional | 53 · Discontinued | $37.15 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $154.88 Typical High $208.93 | Professional | 54 · Surgery only | $141.25 | $154.88 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $30.90 Typical High $42.66 | Professional | 55 · Aftercare only | $28.18 | $30.90 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $20.89 Typical High $28.18 | Professional | 56 · Pre-op care only | $18.62 | $20.89 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $144.54 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $131.83 | $144.54 | $194.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $173.78 Typical High $234.42 | Professional | 51 · Multiple procedures | $128.82 | $173.78 | $234.42 |
Where South Carolina sits
The same service costs 4.2 times more in Alaska than in Virginia. 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· 23rd of 51
$275
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.