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 $138.04 Median $501.19 Typical High $16,595.87 | Facility | None | $138.04 | $501.19 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $208.93 | Professional | None | $131.83 | $177.83 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
BCBS South Carolina Setting Facility Modifier None Typical Low $223.87 Median $380.19 Typical High $676.08 | Facility | None | $223.87 | $380.19 | $676.08 |
BCBS South Carolina Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $181.97 | Professional | None | $93.33 | $112.20 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $151.36 Typical High $245.47 | Facility | None | $75.86 | $151.36 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $338.84 | Professional | None | $120.23 | $186.21 | $338.84 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $120.23 Typical High $275.42 | Facility | None | $89.13 | $120.23 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $263.03 | Professional | None | $173.78 | $213.80 | $263.03 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $302.00 | Professional | None | $144.54 | $208.93 | $302.00 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,025.60 | Facility | None | $302.00 | $1,122.02 | $6,025.60 |
United Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $316.23 | Professional | None | $117.49 | $177.83 | $316.23 |
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 $67.61 Median $74.13 Typical High $102.33 | Professional | 52 · Reduced service | $67.61 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $29.51 Typical High $40.74 | Professional | 53 · Discontinued | $27.54 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $109.65 Typical High $151.36 | Professional | 54 · Surgery only | $102.33 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $22.39 Typical High $30.20 | Professional | 55 · Aftercare only | $20.42 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.79 Typical High $20.42 | Professional | 56 · Pre-op care only | $13.80 | $14.79 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $102.33 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $95.50 | $102.33 | $141.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $346.74 Typical High $489.78 | Professional | 50 · Both sides | $257.04 | $346.74 | $489.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $87.10 Median $117.49 Typical High $165.96 | Professional | 51 · Multiple procedures | $87.10 | $117.49 | $165.96 |
Where South Carolina sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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
$191
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.