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 $194.98 Median $5,623.41 Typical High $21,877.62 | Facility | None | $194.98 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $346.74 | Professional | None | $181.97 | $239.88 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $141.25 | Professional | None | $128.82 | $128.82 | $141.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $2,089.30 Typical High $3,548.13 | Facility | None | $1,174.90 | $2,089.30 | $3,548.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $316.23 | Professional | None | $128.82 | $169.82 | $316.23 |
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 $128.82 Median $251.19 Typical High $398.11 | Professional | None | $128.82 | $251.19 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $194.98 Median $346.74 Typical High $426.58 | Facility | None | $194.98 | $346.74 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $354.81 | Professional | None | $257.04 | $316.23 | $354.81 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $275.42 Typical High $457.09 | Professional | None | $38.02 | $275.42 | $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 $144.54 Median $251.19 Typical High $426.58 | Professional | None | $144.54 | $251.19 | $426.58 |
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 $97.72 Median $123.03 Typical High $173.78 | Professional | 52 · Reduced service | $97.72 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $48.98 Typical High $69.18 | Professional | 53 · Discontinued | $38.90 | $48.98 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $186.21 Typical High $263.03 | Professional | 54 · Surgery only | $147.91 | $186.21 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $37.15 Typical High $52.48 | Professional | 55 · Aftercare only | $29.51 | $37.15 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $24.55 Typical High $34.67 | Professional | 56 · Pre-op care only | $19.50 | $24.55 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $173.78 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $138.04 | $173.78 | $245.47 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $467.74 Typical High $588.84 | Professional | 50 · Both sides | $389.05 | $467.74 | $588.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $154.88 Typical High $199.53 | Professional | 51 · Multiple procedures | $128.82 | $154.88 | $199.53 |
Where South Carolina sits
The same service costs 3.8 times more in Wyoming 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· 39th 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.