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 $169.82 Median $5,623.41 Typical High $21,877.62 | Facility | None | $169.82 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $331.13 | Professional | None | $169.82 | $213.80 | $331.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $660.69 Median $1,096.48 Typical High $3,090.30 | Facility | None | $660.69 | $1,096.48 | $3,090.30 |
BCBS South Carolina Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $389.05 | Professional | None | $114.82 | $194.98 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $676.08 Typical High $1,174.90 | Facility | None | $588.84 | $676.08 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $239.88 Typical High $346.74 | Professional | None | $112.20 | $239.88 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $436.52 Typical High $851.14 | Facility | None | $169.82 | $436.52 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $436.52 | Professional | None | $269.15 | $302.00 | $436.52 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $251.19 Typical High $457.09 | Professional | None | $38.02 | $251.19 | $457.09 |
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 $125.89 Median $234.42 Typical High $407.38 | Professional | None | $125.89 | $234.42 | $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 $85.11 Median $120.23 Typical High $165.96 | Professional | 52 · Reduced service | $85.11 | $120.23 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $47.86 Typical High $67.61 | Professional | 53 · Discontinued | $33.88 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $177.83 Typical High $251.19 | Professional | 54 · Surgery only | $128.82 | $177.83 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $35.48 Typical High $50.12 | Professional | 55 · Aftercare only | $25.70 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $23.99 Typical High $33.11 | Professional | 56 · Pre-op care only | $16.98 | $23.99 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $165.96 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $120.23 | $165.96 | $234.42 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $501.19 Typical High $660.69 | Professional | 50 · Both sides | $407.38 | $501.19 | $660.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $165.96 Typical High $218.78 | Professional | 51 · Multiple procedures | $134.90 | $165.96 | $218.78 |
Where South Carolina sits
The same service costs 4.7 times more in Alaska than in Virginia. 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· 33rd of 51
$269
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.