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 $363.08 Median $562.34 Typical High $21,877.62 | Facility | None | $363.08 | $562.34 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $562.34 | Professional | None | $363.08 | $416.87 | $562.34 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $10,964.78 | Facility | None | $851.14 | $2,630.27 | $10,964.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $446.68 | Professional | None | $251.19 | $281.84 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $1,995.26 | Facility | None | $630.96 | $1,258.93 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $407.38 Typical High $691.83 | Professional | None | $234.42 | $407.38 | $691.83 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $1,174.90 Typical High $1,819.70 | Facility | None | $363.08 | $1,174.90 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $575.44 | Professional | None | $354.81 | $512.86 | $575.44 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $354.81 Typical High $691.83 | Professional | None | $47.86 | $354.81 | $691.83 |
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 $269.15 Median $416.87 Typical High $707.95 | Professional | None | $269.15 | $416.87 | $707.95 |
8 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 $181.97 Median $204.17 Typical High $281.84 | Professional | 52 · Reduced service | $181.97 | $204.17 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $81.28 Typical High $112.20 | Professional | 53 · Discontinued | $72.44 | $81.28 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $426.58 | Professional | 54 · Surgery only | $275.42 | $309.03 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $61.66 Typical High $85.11 | Professional | 55 · Aftercare only | $54.95 | $61.66 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $40.74 Typical High $56.23 | Professional | 56 · Pre-op care only | $36.31 | $40.74 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $288.40 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $257.04 | $288.40 | $398.11 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $776.25 Typical High $954.99 | Professional | 50 · Both sides | $537.03 | $776.25 | $954.99 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $257.04 Typical High $323.59 | Professional | 51 · Multiple procedures | $177.83 | $257.04 | $323.59 |
Where South Carolina sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 38th of 51
$427
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.