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 $549.54 Median $10,471.29 Typical High $21,877.62 | Facility | None | $549.54 | $10,471.29 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $691.83 | Professional | None | $537.03 | $549.54 | $691.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $2,570.40 Typical High $7,943.28 | Facility | None | $1,047.13 | $2,570.40 | $7,943.28 |
BCBS South Carolina Setting Professional Modifier None Typical Low $363.08 Median $575.44 Typical High $676.08 | Professional | None | $363.08 | $575.44 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,230.27 Typical High $1,949.84 | Facility | None | $630.96 | $1,230.27 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $891.25 | Professional | None | $363.08 | $512.86 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $812.83 Typical High $1,380.38 | Facility | None | $524.81 | $812.83 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $891.25 | Professional | None | $549.54 | $616.60 | $891.25 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $436.52 Typical High $831.76 | Professional | None | $89.13 | $436.52 | $831.76 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $912.01 | Professional | None | $407.38 | $524.81 | $912.01 |
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 $269.15 Median $269.15 Typical High $338.84 | Professional | 52 · Reduced service | $269.15 | $269.15 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $138.04 | Professional | 53 · Discontinued | $109.65 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $512.86 | Professional | 54 · Surgery only | $407.38 | $407.38 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $102.33 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $69.18 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $478.63 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,047.13 Typical High $1,348.96 | Professional | 50 · Both sides | $812.83 | $1,047.13 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $346.74 Typical High $446.68 | Professional | 51 · Multiple procedures | $275.42 | $346.74 | $446.68 |
Where South Carolina sits
The same service costs 6.5 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· 36th of 51
$575
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.