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 $245.47 Median $9,120.11 Typical High $21,877.62 | Facility | None | $245.47 | $9,120.11 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $389.05 | Professional | None | $245.47 | $288.40 | $389.05 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,951.21 Median $5,011.87 Typical High $8,912.51 | Facility | None | $2,951.21 | $5,011.87 | $8,912.51 |
BCBS South Carolina Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $467.74 | Professional | None | $169.82 | $229.09 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $436.52 Typical High $741.31 | Facility | None | $275.42 | $436.52 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $489.78 | Professional | None | $208.93 | $309.03 | $489.78 |
Medcost Setting Facility Modifier None Typical Low $245.47 Median $398.11 Typical High $512.86 | Facility | None | $245.47 | $398.11 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $501.19 | Professional | None | $288.40 | $398.11 | $501.19 |
Molina Setting Professional Modifier None Typical Low $40.74 Median $302.00 Typical High $512.86 | Professional | None | $40.74 | $302.00 | $512.86 |
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 $186.21 Median $295.12 Typical High $524.81 | Professional | None | $186.21 | $295.12 | $524.81 |
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 $123.03 Median $141.25 Typical High $194.98 | Professional | 52 · Reduced service | $123.03 | $141.25 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $56.23 Typical High $77.62 | Professional | 53 · Discontinued | $48.98 | $56.23 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $208.93 Typical High $295.12 | Professional | 54 · Surgery only | $186.21 | $208.93 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $41.69 Typical High $58.88 | Professional | 55 · Aftercare only | $37.15 | $41.69 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $28.18 Typical High $38.90 | Professional | 56 · Pre-op care only | $24.55 | $28.18 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $194.98 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $173.78 | $194.98 | $275.42 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $616.60 Typical High $741.31 | Professional | 50 · Both sides | $436.52 | $616.60 | $741.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $144.54 Median $204.17 Typical High $251.19 | Professional | 51 · Multiple procedures | $144.54 | $204.17 | $251.19 |
Where South Carolina sits
The same service costs 4.3 times more in Wyoming 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· 35th of 51
$309
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.