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 $1,348.96 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,348.96 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,318.26 | $1,348.96 | $1,348.96 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $2,454.71 Typical High $10,000.00 | Facility | None | $851.14 | $2,454.71 | $10,000.00 |
BCBS South Carolina Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $1,445.44 | Professional | None | $891.25 | $1,230.27 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,380.38 Typical High $2,238.72 | Facility | None | $602.56 | $1,380.38 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,949.84 | Professional | None | $831.76 | $977.24 | $1,949.84 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $1,000.00 Typical High $2,137.96 | Facility | None | $630.96 | $1,000.00 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,445.44 | Professional | None | $912.01 | $1,202.26 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $776.25 Typical High $1,479.11 | Professional | None | $97.72 | $776.25 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $21,379.62 | Facility | None | $1,445.44 | $4,265.80 | $21,379.62 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,949.84 | Professional | None | $891.25 | $1,096.48 | $1,949.84 |
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 $660.69 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $660.69 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $263.03 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $1,000.00 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $199.53 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $131.83 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $933.25 | $954.99 | $954.99 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,819.70 Typical High $2,290.87 | Professional | 50 · Both sides | $1,380.38 | $1,819.70 | $2,290.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $602.56 Typical High $776.25 | Professional | 51 · Multiple procedures | $457.09 | $602.56 | $776.25 |
Where South Carolina sits
The same service costs 7.6 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· 44th of 51
$1,072
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.