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 $63.10 Median $4,897.79 Typical High $21,877.62 | Facility | None | $63.10 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $97.72 | Professional | None | $63.10 | $93.33 | $97.72 |
BCBS South Carolina Setting Facility Modifier None Typical Low $190.55 Median $257.04 Typical High $616.60 | Facility | None | $190.55 | $257.04 | $616.60 |
BCBS South Carolina Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $114.82 | Professional | None | $54.95 | $95.50 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $77.62 Typical High $794.33 | Facility | None | $60.26 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medcost Setting Facility Modifier None Typical Low $63.10 Median $93.33 Typical High $199.53 | Facility | None | $63.10 | $93.33 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $112.20 | Professional | None | $93.33 | $93.33 | $112.20 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $169.82 | Professional | None | $93.33 | $120.23 | $169.82 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $57.54 Median $91.20 Typical High $177.83 | Professional | None | $57.54 | $91.20 | $177.83 |
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 $31.62 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $31.62 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $12.59 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $69.18 Typical High $69.18 | Professional | 54 · Surgery only | $47.86 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $9.55 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.31 | $9.33 | $9.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $46.77 Median $46.77 Typical High $70.79 | Professional | 51 · Multiple procedures | $46.77 | $46.77 | $70.79 |
Where South Carolina sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 45th of 51
$95.50
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.