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 $954.99 Median $10,964.78 Typical High $21,877.62 | Facility | None | $954.99 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,621.81 Median $3,235.94 Typical High $10,000.00 | Facility | None | $1,621.81 | $3,235.94 | $10,000.00 |
BCBS South Carolina Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,380.38 | Professional | None | $954.99 | $1,096.48 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $2,454.71 | Facility | None | $630.96 | $1,513.56 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $1,348.96 | Professional | None | $562.34 | $676.08 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $851.14 Median $1,258.93 Typical High $1,995.26 | Facility | None | $851.14 | $1,258.93 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $870.96 Typical High $1,621.81 | Professional | None | $575.44 | $870.96 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $398.11 Typical High $660.69 | Professional | None | $112.20 | $398.11 | $660.69 |
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 $630.96 Median $776.25 Typical High $1,380.38 | Professional | None | $630.96 | $776.25 | $1,380.38 |
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 $467.74 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $467.74 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $141.25 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $660.69 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,348.96 Typical High $2,398.83 | Professional | 50 · Both sides | $870.96 | $1,348.96 | $2,398.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $288.40 Median $501.19 Typical High $812.83 | Professional | 51 · Multiple procedures | $288.40 | $501.19 | $812.83 |
Where South Carolina sits
The same service costs 4.6 times more in Alaska than in New York. 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
$1,047
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.