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 $141.25 Median $4,897.79 Typical High $21,877.62 | Facility | None | $141.25 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $234.42 | Professional | None | $131.83 | $169.82 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $208.93 | Professional | None | $125.89 | $147.91 | $208.93 |
BCBS South Carolina Setting Facility Modifier None Typical Low $363.08 Median $630.96 Typical High $1,174.90 | Facility | None | $363.08 | $630.96 | $1,174.90 |
BCBS South Carolina Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $263.03 | Professional | None | $104.71 | $162.18 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $95.50 Typical High $724.44 | Facility | None | $75.86 | $95.50 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $251.19 | Professional | None | $162.18 | $190.55 | $251.19 |
Medcost Setting Facility Modifier None Typical Low $77.62 Median $128.82 Typical High $194.98 | Facility | None | $77.62 | $128.82 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $181.97 Typical High $204.17 | Professional | None | $173.78 | $181.97 | $204.17 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $251.19 | Professional | None | $102.33 | $162.18 | $251.19 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $245.47 | Professional | None | $109.65 | $144.54 | $245.47 |
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 $69.18 Median $70.79 Typical High $89.13 | Professional | 52 · Reduced service | $69.18 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $28.18 Typical High $35.48 | Professional | 53 · Discontinued | $27.54 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $107.15 Typical High $134.90 | Professional | 54 · Surgery only | $102.33 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $21.38 Typical High $26.92 | Professional | 55 · Aftercare only | $20.42 | $21.38 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.13 Typical High $17.78 | Professional | 56 · Pre-op care only | $13.80 | $14.13 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $100.00 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $95.50 | $100.00 | $125.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $89.13 Median $89.13 Typical High $134.90 | Professional | 51 · Multiple procedures | $89.13 | $89.13 | $134.90 |
Where South Carolina sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 33rd of 51
$170
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.