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 $181.97 Median $5,623.41 Typical High $21,877.62 | Facility | None | $181.97 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $295.12 | Professional | None | $158.49 | $208.93 | $295.12 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,290.87 Median $3,715.35 Typical High $6,918.31 | Facility | None | $2,290.87 | $3,715.35 | $6,918.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $257.04 | Professional | None | $123.03 | $173.78 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $398.11 Typical High $707.95 | Facility | None | $194.98 | $398.11 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $346.74 | Professional | None | $120.23 | $199.53 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $281.84 Typical High $371.54 | Facility | None | $181.97 | $281.84 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $354.81 | Professional | None | $218.78 | $269.15 | $354.81 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $213.80 Typical High $389.05 | Professional | None | $38.02 | $213.80 | $389.05 |
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 $134.90 Median $213.80 Typical High $354.81 | Professional | None | $134.90 | $213.80 | $354.81 |
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 $91.20 Median $104.71 Typical High $147.91 | Professional | 52 · Reduced service | $91.20 | $104.71 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $41.69 Typical High $58.88 | Professional | 53 · Discontinued | $36.31 | $41.69 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $158.49 Typical High $218.78 | Professional | 54 · Surgery only | $138.04 | $158.49 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $31.62 Typical High $43.65 | Professional | 55 · Aftercare only | $27.54 | $31.62 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.89 Typical High $29.51 | Professional | 56 · Pre-op care only | $18.20 | $20.89 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $147.91 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $128.82 | $147.91 | $204.17 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $426.58 Typical High $537.03 | Professional | 50 · Both sides | $323.59 | $426.58 | $537.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $109.65 Median $144.54 Typical High $177.83 | Professional | 51 · Multiple procedures | $109.65 | $144.54 | $177.83 |
Where South Carolina sits
The same service costs 4.2 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· 37th of 51
$224
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.