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 $144.54 Median $4,897.79 Typical High $21,877.62 | Facility | None | $144.54 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $165.96 | Professional | None | $109.65 | $144.54 | $165.96 |
BCBS South Carolina Setting Facility Modifier None Typical Low $331.13 Median $588.84 Typical High $1,000.00 | Facility | None | $331.13 | $588.84 | $1,000.00 |
BCBS South Carolina Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $295.12 | Professional | None | $87.10 | $100.00 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $102.33 Typical High $162.18 | Facility | None | $75.86 | $102.33 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $223.87 | Professional | None | $85.11 | $114.82 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $138.04 Typical High $194.98 | Facility | None | $89.13 | $138.04 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $151.36 | Professional | None | $107.15 | $138.04 | $151.36 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $245.47 | Professional | None | $104.71 | $162.18 | $245.47 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $218.78 | Professional | None | $100.00 | $125.89 | $218.78 |
9 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 $72.44 Median $72.44 Typical High $83.18 | Professional | 52 · Reduced service | $72.44 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $33.11 | Professional | 53 · Discontinued | $28.84 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 54 · Surgery only | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $24.55 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $16.60 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $102.33 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $102.33 | $102.33 | $114.82 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 50 · Both sides | $190.55 | $190.55 | $190.55 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $208.93 Typical High $281.84 | Professional | 50 · Both sides | $162.18 | $208.93 | $281.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $53.70 Median $72.44 Typical High $93.33 | Professional | 51 · Multiple procedures | $53.70 | $72.44 | $93.33 |
Where South Carolina sits
The same service costs 4.4 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· 32nd of 51
$141
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.