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 $1,071.52 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,071.52 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,000.00 | $1,071.52 | $1,071.52 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,019.95 Typical High $10,964.78 | Facility | None | $851.14 | $3,019.95 | $10,964.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $954.99 | Professional | None | $724.44 | $794.33 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,630.27 | Facility | None | $602.56 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $1,513.56 | Professional | None | $602.56 | $676.08 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $1,000.00 Typical High $2,187.76 | Facility | None | $616.60 | $1,000.00 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $977.24 | Professional | None | $645.65 | $851.14 | $977.24 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $630.96 Typical High $1,230.27 | Professional | None | $97.72 | $630.96 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,445.44 | Professional | None | $645.65 | $812.83 | $1,445.44 |
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 $501.19 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $501.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $204.17 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $758.58 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $151.36 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $707.95 | $741.31 | $741.31 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,258.93 Typical High $1,819.70 | Professional | 50 · Both sides | $977.24 | $1,258.93 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $323.59 Median $426.58 Typical High $602.56 | Professional | 51 · Multiple procedures | $323.59 | $426.58 | $602.56 |
Where South Carolina sits
The same service costs 8.3 times more in Wyoming 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· 44th of 51
$794
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.