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 $97.72 Median $120.23 Typical High $21,877.62 | Facility | None | $97.72 | $120.23 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $128.82 | Professional | None | $97.72 | $109.65 | $128.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $147.91 Median $251.19 Typical High $446.68 | Facility | None | $147.91 | $251.19 | $446.68 |
BCBS South Carolina Setting Professional Modifier None Typical Low $64.57 Median $67.61 Typical High $263.03 | Professional | None | $64.57 | $67.61 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $794.33 | Facility | None | $52.48 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $169.82 | Professional | None | $85.11 | $102.33 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $45.71 Median $70.79 Typical High $144.54 | Facility | None | $45.71 | $70.79 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $109.65 Typical High $158.49 | Professional | None | $70.79 | $109.65 | $158.49 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $190.55 | Professional | None | $95.50 | $147.91 | $190.55 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $74.13 Median $100.00 Typical High $181.97 | Professional | None | $74.13 | $100.00 | $181.97 |
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 $48.98 Median $48.98 Typical High $60.26 | Professional | 52 · Reduced service | $48.98 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $23.99 | Professional | 53 · Discontinued | $19.50 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $89.13 | Professional | 54 · Surgery only | $74.13 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $17.78 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $69.18 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $69.18 | $69.18 | $83.18 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $204.17 Typical High $239.88 | Professional | 50 · Both sides | $107.15 | $204.17 | $239.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $35.48 Median $67.61 Typical High $79.43 | Professional | 51 · Multiple procedures | $35.48 | $67.61 | $79.43 |
Where South Carolina sits
The same service costs 4.2 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
$110
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.