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 $1,122.02 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,122.02 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,122.02 | Professional | None | $933.25 | $1,122.02 | $1,122.02 |
BCBS South Carolina Setting Facility Modifier None Typical Low $776.25 Median $1,548.82 Typical High $3,019.95 | Facility | None | $776.25 | $1,548.82 | $3,019.95 |
BCBS South Carolina Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,071.52 | Professional | None | $741.31 | $891.25 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $645.65 Typical High $1,318.26 | Facility | None | $549.54 | $645.65 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,621.81 | Professional | None | $870.96 | $870.96 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $346.74 Median $741.31 Typical High $1,513.56 | Facility | None | $346.74 | $741.31 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,258.93 | Professional | None | $831.76 | $1,023.29 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $812.83 Typical High $1,348.96 | Professional | None | $117.49 | $812.83 | $1,348.96 |
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 $724.44 Median $891.25 Typical High $1,479.11 | Professional | None | $724.44 | $891.25 | $1,479.11 |
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 $457.09 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $457.09 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $186.21 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $691.83 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $138.04 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $93.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $645.65 | $776.25 | $776.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $512.86 Typical High $831.76 | Professional | 51 · Multiple procedures | $416.87 | $512.86 | $831.76 |
Where South Carolina sits
The same service costs 22.4 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· 42nd of 51
$891
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.