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 $1,230.27 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,230.27 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,230.27 | $1,230.27 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $1,995.26 Typical High $7,762.47 | Facility | None | $851.14 | $1,995.26 | $7,762.47 |
BCBS South Carolina Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,122.02 | Professional | None | $812.83 | $933.25 | $1,122.02 |
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 $741.31 Median $851.14 Typical High $1,737.80 | Professional | None | $741.31 | $851.14 | $1,737.80 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,698.24 | Facility | None | $630.96 | $851.14 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,174.90 | Professional | None | $776.25 | $1,071.52 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $724.44 Typical High $1,380.38 | Professional | None | $102.33 | $724.44 | $1,380.38 |
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 $776.25 Median $977.24 Typical High $1,737.80 | Professional | None | $776.25 | $977.24 | $1,737.80 |
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 $588.84 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $588.84 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $234.42 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $891.25 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $177.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $117.49 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $831.76 | $851.14 | $851.14 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,621.81 Typical High $2,089.30 | Professional | 50 · Both sides | $1,148.15 | $1,621.81 | $2,089.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $537.03 Typical High $691.83 | Professional | 51 · Multiple procedures | $380.19 | $537.03 | $691.83 |
Where South Carolina sits
The same service costs 7.4 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· 44th of 51
$933
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.