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 $1,318.26 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,318.26 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,148.15 | $1,318.26 | $1,318.26 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,019.95 Typical High $10,964.78 | Facility | None | $851.14 | $3,019.95 | $10,964.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,202.26 | Professional | None | $870.96 | $1,000.00 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,630.27 | Facility | None | $602.56 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,862.09 | Professional | None | $794.33 | $912.01 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $1,000.00 Typical High $2,187.76 | Facility | None | $630.96 | $1,000.00 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,230.27 | Professional | None | $831.76 | $1,148.15 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $776.25 Typical High $1,445.44 | Professional | None | $102.33 | $776.25 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,819.70 | Professional | None | $831.76 | $1,047.13 | $1,819.70 |
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 $630.96 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $630.96 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $251.19 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $954.99 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $190.55 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $125.89 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $891.25 | $912.01 | $912.01 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,698.24 Typical High $2,238.72 | Professional | 50 · Both sides | $1,258.93 | $1,698.24 | $2,238.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $575.44 Typical High $741.31 | Professional | 51 · Multiple procedures | $416.87 | $575.44 | $741.31 |
Where South Carolina sits
The same service costs 7.2 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· 43rd of 51
$1,000
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.