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 $1,380.38 Median $5,888.44 Typical High $21,877.62 | Facility | None | $1,380.38 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,445.44 | Professional | None | $1,380.38 | $1,380.38 | $1,445.44 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,467.37 Median $6,456.54 Typical High $10,715.19 | Facility | None | $3,467.37 | $6,456.54 | $10,715.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $512.86 | Professional | None | $478.63 | $478.63 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $13,182.57 Typical High $18,620.87 | Facility | None | $602.56 | $13,182.57 | $18,620.87 |
Cigna Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $36,307.81 | Facility | None | $1,380.38 | $1,621.81 | $36,307.81 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,348.96 | $1,698.24 |
United Setting Facility Modifier None Typical Low $5,623.41 Median $22,387.21 Typical High $43,651.58 | Facility | None | $5,623.41 | $22,387.21 | $43,651.58 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,513.56 | $2,290.87 |
7 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 $691.83 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $138.04 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,041.74 Typical High $3,162.28 | Professional | 50 · Both sides | $2,041.74 | $2,041.74 | $3,162.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $676.08 Median $676.08 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $676.08 | $676.08 | $1,047.13 |
Where South Carolina sits
The same service costs 6.9 times more in Arkansas 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· 9th of 51
$3,236
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.