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 $138.04 Median $4,897.79 Typical High $21,877.62 | Facility | None | $138.04 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $218.78 | Professional | None | $138.04 | $154.88 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
BCBS South Carolina Setting Facility Modifier None Typical Low $501.19 Median $851.14 Typical High $2,238.72 | Facility | None | $501.19 | $851.14 | $2,238.72 |
BCBS South Carolina Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $165.96 | Professional | None | $91.20 | $114.82 | $165.96 |
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 $89.13 Median $141.25 Typical High $263.03 | Professional | None | $89.13 | $141.25 | $263.03 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $436.52 Typical High $812.83 | Facility | None | $123.03 | $436.52 | $812.83 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $199.53 | Professional | None | $128.82 | $165.96 | $199.53 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $302.00 | Professional | None | $134.90 | $208.93 | $302.00 |
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 $102.33 Median $158.49 Typical High $269.15 | Professional | None | $102.33 | $158.49 | $269.15 |
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 $69.18 Median $79.43 Typical High $109.65 | Professional | 52 · Reduced service | $69.18 | $79.43 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $31.62 Typical High $43.65 | Professional | 53 · Discontinued | $27.54 | $31.62 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $117.49 Typical High $165.96 | Professional | 54 · Surgery only | $102.33 | $117.49 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $23.44 Typical High $33.11 | Professional | 55 · Aftercare only | $20.89 | $23.44 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.85 Typical High $21.88 | Professional | 56 · Pre-op care only | $13.80 | $15.85 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $109.65 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $95.50 | $109.65 | $154.88 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $245.47 Typical High $371.54 | Professional | 50 · Both sides | $194.98 | $245.47 | $371.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $64.57 Median $83.18 Typical High $125.89 | Professional | 51 · Multiple procedures | $64.57 | $83.18 | $125.89 |
Where South Carolina sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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· 34th of 51
$174
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.