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 $416.87 Median $4,897.79 Typical High $21,877.62 | Facility | None | $416.87 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $416.87 Typical High $537.03 | Professional | None | $407.38 | $416.87 | $537.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,951.21 Median $5,011.87 Typical High $8,912.51 | Facility | None | $2,951.21 | $5,011.87 | $8,912.51 |
BCBS South Carolina Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $416.87 | Professional | None | $245.47 | $302.00 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $549.54 Typical High $1,318.26 | Facility | None | $331.13 | $549.54 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $691.83 | Professional | None | $263.03 | $363.08 | $691.83 |
Medcost Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $602.56 | Facility | None | $269.15 | $426.58 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $489.78 | Professional | None | $338.84 | $426.58 | $489.78 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $346.74 Typical High $676.08 | Professional | None | $47.86 | $346.74 | $676.08 |
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 $302.00 Median $398.11 Typical High $691.83 | Professional | None | $302.00 | $398.11 | $691.83 |
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 $208.93 Median $208.93 Typical High $269.15 | Professional | 52 · Reduced service | $208.93 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $109.65 | Professional | 53 · Discontinued | $85.11 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $407.38 | Professional | 54 · Surgery only | $316.23 | $316.23 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $81.28 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $42.66 Typical High $53.70 | Professional | 56 · Pre-op care only | $41.69 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $380.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $630.96 Typical High $933.25 | Professional | 50 · Both sides | $501.19 | $630.96 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $208.93 Typical High $309.03 | Professional | 51 · Multiple procedures | $165.96 | $208.93 | $309.03 |
Where South Carolina sits
The same service costs 5.0 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· 43rd of 51
$380
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.