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 $389.05 Median $9,120.11 Typical High $21,877.62 | Facility | None | $389.05 | $9,120.11 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $588.84 | Professional | None | $295.12 | $389.05 | $588.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $1,862.09 Typical High $7,762.47 | Facility | None | $851.14 | $1,862.09 | $7,762.47 |
BCBS South Carolina Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $537.03 | Professional | None | $263.03 | $371.54 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $1,949.84 | Facility | None | $602.56 | $1,230.27 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $724.44 | Professional | None | $218.78 | $346.74 | $724.44 |
Medcost Setting Facility Modifier None Typical Low $389.05 Median $645.65 Typical High $1,288.25 | Facility | None | $389.05 | $645.65 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $549.54 | Professional | None | $426.58 | $457.09 | $549.54 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $371.54 Typical High $741.31 | Professional | None | $47.86 | $371.54 | $741.31 |
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 $269.15 Median $407.38 Typical High $707.95 | Professional | None | $269.15 | $407.38 | $707.95 |
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 $194.98 Median $218.78 Typical High $295.12 | Professional | 52 · Reduced service | $194.98 | $218.78 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $87.10 Typical High $117.49 | Professional | 53 · Discontinued | $77.62 | $87.10 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $323.59 Typical High $446.68 | Professional | 54 · Surgery only | $288.40 | $323.59 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $64.57 Typical High $89.13 | Professional | 55 · Aftercare only | $57.54 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $43.65 Typical High $58.88 | Professional | 56 · Pre-op care only | $38.90 | $43.65 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $302.00 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $269.15 | $302.00 | $416.87 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $691.83 Typical High $1,000.00 | Professional | 50 · Both sides | $630.96 | $691.83 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $213.80 Median $229.09 Typical High $338.84 | Professional | 51 · Multiple procedures | $213.80 | $229.09 | $338.84 |
Where South Carolina sits
The same service costs 5.9 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· 37th of 51
$447
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.