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 $331.13 Median $5,888.44 Typical High $21,877.62 | Facility | None | $331.13 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $407.38 | Professional | None | $331.13 | $331.13 | $407.38 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,000.00 Median $1,905.46 Typical High $4,168.69 | Facility | None | $1,000.00 | $1,905.46 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,412.54 Typical High $2,187.76 | Facility | None | $602.56 | $1,412.54 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $398.11 Typical High $1,949.84 | Facility | None | $331.13 | $398.11 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $616.60 | Professional | None | $363.08 | $363.08 | $616.60 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $977.24 | Professional | None | $426.58 | $645.65 | $977.24 |
5 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 $165.96 Median $165.96 Typical High $190.55 | Professional | 52 · Reduced service | $165.96 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $75.86 | Professional | 53 · Discontinued | $66.07 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | 54 · Surgery only | $245.47 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $57.54 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $38.02 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $38.02 |
Where South Carolina sits
The same service costs 8.1 times more in Texas than in New York. 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· 7th of 51
$1,259
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.