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 $1,096.48 Median $12,022.64 Typical High $21,877.62 | Facility | None | $1,096.48 | $12,022.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $1,148.15 | Professional | None | $1,047.13 | $1,096.48 | $1,148.15 |
BCBS South Carolina Setting Facility Modifier None Typical Low $7,762.47 Median $13,182.57 Typical High $23,988.33 | Facility | None | $7,762.47 | $13,182.57 | $23,988.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,995.26 | Professional | None | $933.25 | $1,096.48 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $22,908.68 Median $44,668.36 Typical High $61,659.50 | Facility | None | $22,908.68 | $44,668.36 | $61,659.50 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,258.93 | $2,630.27 |
Medcost Setting Facility Modifier None Typical Low $977.24 Median $1,096.48 Typical High $2,951.21 | Facility | None | $977.24 | $1,096.48 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,548.82 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $1,023.29 Typical High $1,737.80 | Professional | None | $97.72 | $1,023.29 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,258.93 | $1,995.26 |
6 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 $524.81 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $524.81 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $213.80 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $794.33 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $158.49 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $104.71 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $741.31 | $758.58 | $758.58 |
Where South Carolina sits
The same service costs 8.9 times more in Oklahoma 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· 48th of 51
$1,148
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.