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 $144.54 Median $4,897.79 Typical High $21,877.62 | Facility | None | $144.54 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $354.81 | Professional | None | $138.04 | $213.80 | $354.81 |
BCBS South Carolina Setting Facility Modifier None Typical Low $489.78 Median $831.76 Typical High $1,479.11 | Facility | None | $489.78 | $831.76 | $1,479.11 |
BCBS South Carolina Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $275.42 | Professional | None | $93.33 | $102.33 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $389.05 Typical High $707.95 | Facility | None | $194.98 | $389.05 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $245.47 Typical High $346.74 | Professional | None | $93.33 | $245.47 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $223.87 Typical High $354.81 | Facility | None | $141.25 | $223.87 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $316.23 | Professional | None | $223.87 | $295.12 | $316.23 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $269.15 Typical High $457.09 | Professional | None | $38.02 | $269.15 | $457.09 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $107.15 Median $229.09 Typical High $407.38 | Professional | None | $107.15 | $229.09 | $407.38 |
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 $72.44 Median $102.33 Typical High $173.78 | Professional | 52 · Reduced service | $72.44 | $102.33 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $40.74 Typical High $70.79 | Professional | 53 · Discontinued | $28.84 | $40.74 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $154.88 Typical High $263.03 | Professional | 54 · Surgery only | $107.15 | $154.88 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $30.90 Typical High $52.48 | Professional | 55 · Aftercare only | $21.88 | $30.90 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.42 Typical High $35.48 | Professional | 56 · Pre-op care only | $14.45 | $20.42 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $144.54 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $100.00 | $144.54 | $245.47 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $446.68 Typical High $602.56 | Professional | 50 · Both sides | $331.13 | $446.68 | $602.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $109.65 Median $147.91 Typical High $199.53 | Professional | 51 · Multiple procedures | $109.65 | $147.91 | $199.53 |
Where South Carolina sits
The same service costs 4.2 times more in Wisconsin 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· 25th of 51
$263
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.