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 $186.21 Median $4,897.79 Typical High $21,877.62 | Facility | None | $186.21 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $194.98 | Professional | None | $151.36 | $186.21 | $194.98 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $2,089.30 Typical High $3,630.78 | Facility | None | $1,202.26 | $2,089.30 | $3,630.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $281.84 | Professional | None | $123.03 | $131.83 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $234.42 Typical High $707.95 | Facility | None | $104.71 | $234.42 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $263.03 | Professional | None | $123.03 | $147.91 | $263.03 |
Medcost Setting Facility Modifier None Typical Low $100.00 Median $151.36 Typical High $251.19 | Facility | None | $100.00 | $151.36 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $338.84 | Professional | None | $151.36 | $181.97 | $338.84 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $309.03 | Professional | None | $104.71 | $177.83 | $309.03 |
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 $128.82 Median $162.18 Typical High $302.00 | Professional | None | $128.82 | $162.18 | $302.00 |
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 $93.33 Median $93.33 Typical High $97.72 | Professional | 52 · Reduced service | $93.33 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $39.81 | Professional | 53 · Discontinued | $37.15 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $147.91 | Professional | 54 · Surgery only | $138.04 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $19.50 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $138.04 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $338.84 Typical High $501.19 | Professional | 50 · Both sides | $229.09 | $338.84 | $501.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $75.86 Median $112.20 Typical High $165.96 | Professional | 51 · Multiple procedures | $75.86 | $112.20 | $165.96 |
Where South Carolina sits
The same service costs 4.6 times more in Alaska than in Florida. 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
$178
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.