How much rates vary
Facilitymedian $794 · 10th to 90th $389 to $2,754Professionalmedian $550 · 10th to 90th $112 to $955
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 $616.60 Median $10,964.78 Typical High $21,877.62 | Facility | None | $616.60 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $691.83 | Professional | None | $562.34 | $630.96 | $691.83 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $912.01 | Professional | None | $489.78 | $489.78 | $912.01 |
BCBS South Carolina Setting Facility Modifier None Typical Low $489.78 Median $794.33 Typical High $2,187.76 | Facility | None | $489.78 | $794.33 | $2,187.76 |
BCBS South Carolina Setting Professional Modifier None Typical Low $407.38 Median $933.25 Typical High $977.24 | Professional | None | $407.38 | $933.25 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $457.09 Typical High $741.31 | Facility | None | $331.13 | $457.09 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $891.25 | Professional | None | $537.03 | $616.60 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $295.12 Median $524.81 Typical High $831.76 | Facility | None | $295.12 | $524.81 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $891.25 | Professional | None | $575.44 | $676.08 | $891.25 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $398.11 Typical High $794.33 | Professional | None | $89.13 | $398.11 | $794.33 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,025.60 | Facility | None | $302.00 | $1,122.02 | $6,025.60 |
United Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $1,047.13 | Professional | None | $457.09 | $575.44 | $1,047.13 |
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 $309.03 Median $309.03 Typical High $323.59 | Professional | 52 · Reduced service | $309.03 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $128.82 | Professional | 53 · Discontinued | $123.03 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $467.74 Typical High $478.63 | Professional | 54 · Surgery only | $457.09 | $467.74 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $95.50 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $64.57 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $436.52 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $426.58 | $436.52 | $446.68 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,174.90 Typical High $1,348.96 | Professional | 50 · Both sides | $851.14 | $1,174.90 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $288.40 Median $389.05 Typical High $446.68 | Professional | 51 · Multiple procedures | $288.40 | $389.05 | $446.68 |
Where South Carolina sits
The same service costs 6.2 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· 36th of 51
$575
AK $1,995UT $324
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.