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 $1,023.29 Median $12,022.64 Typical High $21,877.62 | Facility | None | $1,023.29 | $12,022.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,023.29 | Professional | None | $912.01 | $1,023.29 | $1,023.29 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,698.24 Median $5,495.41 Typical High $17,378.01 | Facility | None | $1,698.24 | $5,495.41 | $17,378.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,659.59 | Professional | None | $776.25 | $1,047.13 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,311.31 Typical High $4,677.35 | Facility | None | $630.96 | $3,311.31 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,905.46 | Professional | None | $954.99 | $1,000.00 | $1,905.46 |
Medcost Setting Facility Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $3,311.31 | Facility | None | $1,023.29 | $1,445.44 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,122.02 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $741.31 Typical High $1,318.26 | Professional | None | $97.72 | $741.31 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,819.70 | Professional | None | $870.96 | $1,071.52 | $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 $457.09 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $457.09 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $181.97 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $676.08 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $134.90 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $91.20 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $630.96 | $707.95 | $707.95 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,698.24 Typical High $2,454.71 | Professional | 50 · Both sides | $1,584.89 | $1,698.24 | $2,454.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $562.34 Typical High $812.83 | Professional | 51 · Multiple procedures | $524.81 | $562.34 | $812.83 |
Where South Carolina sits
The same service costs 7.2 times more in Alaska than in Texas. 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
$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.