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 $616.60 Median $4,897.79 Typical High $21,877.62 | Facility | None | $616.60 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $724.44 | Professional | None | $616.60 | $660.69 | $724.44 |
BCBS South Carolina Setting Facility Modifier None Typical Low $891.25 Median $1,513.56 Typical High $2,691.53 | Facility | None | $891.25 | $1,513.56 | $2,691.53 |
BCBS South Carolina Setting Professional Modifier None Typical Low $407.38 Median $1,071.52 Typical High $1,122.02 | Professional | None | $407.38 | $1,071.52 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $457.09 Typical High $758.58 | Facility | None | $338.84 | $457.09 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $1,174.90 | Professional | None | $630.96 | $933.25 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $295.12 Median $575.44 Typical High $831.76 | Facility | None | $295.12 | $575.44 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $1,288.25 | Professional | None | $602.56 | $870.96 | $1,288.25 |
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 $724.44 Typical High $1,380.38 | Professional | None | $457.09 | $724.44 | $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 $309.03 Median $309.03 Typical High $331.13 | Professional | 52 · Reduced service | $309.03 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | 53 · Discontinued | $123.03 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $489.78 | Professional | 54 · Surgery only | $467.74 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $97.72 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $457.09 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,318.26 Typical High $1,905.46 | Professional | 50 · Both sides | $1,122.02 | $1,318.26 | $1,905.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $436.52 Typical High $630.96 | Professional | 51 · Multiple procedures | $371.54 | $436.52 | $630.96 |
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· 38th of 51
$617
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.