How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $602,559.59 Median $602,559.59 Typical High $602,559.59 | Facility | None | $602,559.59 | $602,559.59 | $602,559.59 |
Aetna Setting Professional Modifier None Typical Low $575,439.94 Median $602,559.59 Typical High $602,559.59 | Professional | None | $575,439.94 | $602,559.59 | $602,559.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $288,403.15 Median $301,995.17 Typical High $301,995.17 | Professional | 52 · Reduced service | $288,403.15 | $301,995.17 | $301,995.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114,815.36 Median $123,026.88 Typical High $123,026.88 | Professional | 53 · Discontinued | $114,815.36 | $123,026.88 | $123,026.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87,096.36 Median $91,201.08 Typical High $91,201.08 | Professional | 55 · Aftercare only | $87,096.36 | $91,201.08 | $91,201.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57,543.99 Median $60,255.96 Typical High $60,255.96 | Professional | 56 · Pre-op care only | $57,543.99 | $60,255.96 | $60,255.96 |
BCBS South Carolina Setting Professional Modifier None Typical Low $575,439.94 Median $575,439.94 Typical High $602,559.59 | Professional | None | $575,439.94 | $575,439.94 | $602,559.59 |
Medcost Setting Facility Modifier None Typical Low $602,559.59 Median $724,435.96 Typical High $1,479,108.39 | Facility | None | $602,559.59 | $724,435.96 | $1,479,108.39 |
Medcost Setting Professional Modifier None Typical Low $407,380.28 Median $407,380.28 Typical High $676,082.98 | Professional | None | $407,380.28 | $407,380.28 | $676,082.98 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $54.95 Typical High $1,445,439.77 | Professional | None | $30.20 | $54.95 | $1,445,439.77 |
United Setting Facility Modifier None Typical Low $575,439.94 Median $575,439.94 Typical High $1,258,925.41 | Facility | None | $575,439.94 | $575,439.94 | $1,258,925.41 |
United Setting Professional Modifier None Typical Low $562,341.33 Median $562,341.33 Typical High $741,310.24 | Professional | None | $562,341.33 | $562,341.33 | $741,310.24 |
1 more rate 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $204,173.79 Median $204,173.79 Typical High $204,173.79 | Professional | 51 · Multiple procedures | $204,173.79 | $204,173.79 | $204,173.79 |
Where South Carolina sits
The same service costs 1.7 times more in Texas than in Minnesota. 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· 49th of 51
$575,440
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.