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 $162.18 Median $4,897.79 Typical High $21,877.62 | Facility | None | $162.18 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $245.47 | Professional | None | $162.18 | $190.55 | $245.47 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,412.54 Typical High $6,760.83 | Facility | None | $512.86 | $1,412.54 | $6,760.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $199.53 | Professional | None | $109.65 | $181.97 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,380.38 Typical High $1,905.46 | Facility | None | $457.09 | $1,380.38 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $309.03 | Professional | None | $107.15 | $158.49 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $436.52 Typical High $812.83 | Facility | None | $141.25 | $436.52 | $812.83 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $223.87 | Professional | None | $147.91 | $208.93 | $223.87 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $346.74 | Professional | None | $147.91 | $229.09 | $346.74 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $302.00 | Professional | None | $120.23 | $177.83 | $302.00 |
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 $81.28 Median $91.20 Typical High $123.03 | Professional | 52 · Reduced service | $81.28 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $36.31 Typical High $48.98 | Professional | 53 · Discontinued | $32.36 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $134.90 Typical High $181.97 | Professional | 54 · Surgery only | $123.03 | $134.90 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $27.54 Typical High $36.31 | Professional | 55 · Aftercare only | $24.55 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $18.20 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.22 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $125.89 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $114.82 | $125.89 | $169.82 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $223.87 Median $316.23 Typical High $416.87 | Professional | 50 · Both sides | $223.87 | $316.23 | $416.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $104.71 Typical High $138.04 | Professional | 51 · Multiple procedures | $74.13 | $104.71 | $138.04 |
Where South Carolina sits
The same service costs 4.7 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· 30th of 51
$209
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.