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 $707.95 Median $10,964.78 Typical High $21,877.62 | Facility | None | $707.95 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $707.95 Typical High $707.95 | Professional | None | $691.83 | $707.95 | $707.95 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $2,238.72 Typical High $6,918.31 | Facility | None | $1,047.13 | $2,238.72 | $6,918.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $741.31 | Professional | None | $478.63 | $645.65 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,230.27 Typical High $1,949.84 | Facility | None | $630.96 | $1,230.27 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $1,023.29 | Professional | None | $436.52 | $512.86 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $812.83 Typical High $1,548.82 | Facility | None | $630.96 | $812.83 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $1,174.90 | Professional | None | $489.78 | $645.65 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $389.05 Typical High $812.83 | Professional | None | $89.13 | $389.05 | $812.83 |
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 $457.09 Median $575.44 Typical High $1,023.29 | Professional | None | $457.09 | $575.44 | $1,023.29 |
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 $346.74 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $346.74 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $138.04 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $512.86 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $104.71 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $69.18 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $478.63 | $501.19 | $501.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $1,047.13 Typical High $1,778.28 | Professional | 50 · Both sides | $741.31 | $1,047.13 | $1,778.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $245.47 Median $346.74 Typical High $588.84 | Professional | 51 · Multiple procedures | $245.47 | $346.74 | $588.84 |
Where South Carolina sits
The same service costs 8.5 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· 41st of 51
$589
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.