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 $120.23 Median $4,897.79 Typical High $21,877.62 | Facility | None | $120.23 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $302.00 | Professional | None | $120.23 | $177.83 | $302.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $2,089.30 Typical High $3,630.78 | Facility | None | $1,174.90 | $2,089.30 | $3,630.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $251.19 | Professional | None | $75.86 | $102.33 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $707.95 | Facility | None | $229.09 | $398.11 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $208.93 Typical High $302.00 | Professional | None | $77.62 | $208.93 | $302.00 |
Medcost Setting Facility Modifier None Typical Low $120.23 Median $302.00 Typical High $338.84 | Facility | None | $120.23 | $302.00 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $295.12 | Professional | None | $218.78 | $251.19 | $295.12 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $234.42 Typical High $398.11 | Professional | None | $38.02 | $234.42 | $398.11 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $89.13 Median $194.98 Typical High $338.84 | Professional | None | $89.13 | $194.98 | $338.84 |
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 $60.26 Median $85.11 Typical High $151.36 | Professional | 52 · Reduced service | $60.26 | $85.11 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $34.67 Typical High $60.26 | Professional | 53 · Discontinued | $24.55 | $34.67 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $128.82 Typical High $223.87 | Professional | 54 · Surgery only | $91.20 | $128.82 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $25.70 Typical High $44.67 | Professional | 55 · Aftercare only | $18.20 | $25.70 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $16.98 Typical High $30.20 | Professional | 56 · Pre-op care only | $12.02 | $16.98 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $120.23 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $85.11 | $120.23 | $208.93 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $371.54 Typical High $512.86 | Professional | 50 · Both sides | $323.59 | $371.54 | $512.86 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $109.65 Median $125.89 Typical High $169.82 | Professional | 51 · Multiple procedures | $109.65 | $125.89 | $169.82 |
Where South Carolina sits
The same service costs 5.6 times more in Alaska 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· 31st of 51
$224
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.