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 $281.84 Median $5,623.41 Typical High $21,877.62 | Facility | None | $281.84 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $295.12 | Professional | None | $281.84 | $281.84 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
BCBS South Carolina Setting Facility Modifier None Typical Low $467.74 Median $676.08 Typical High $1,258.93 | Facility | None | $467.74 | $676.08 | $1,258.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $102.33 | Professional | None | $69.18 | $69.18 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $562.34 Typical High $891.25 | Facility | None | $457.09 | $562.34 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $158.49 Median $309.03 Typical High $426.58 | Facility | None | $158.49 | $309.03 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $151.36 Typical High $338.84 | Professional | None | $147.91 | $151.36 | $338.84 |
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 $302.00 Median $1,122.02 Typical High $6,025.60 | Facility | None | $302.00 | $1,122.02 | $6,025.60 |
United Setting Professional Modifier None Typical Low $151.36 Median $302.00 Typical High $489.78 | Professional | None | $151.36 | $302.00 | $489.78 |
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 $141.25 Median $141.25 Typical High $147.91 | Professional | 52 · Reduced service | $141.25 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | 53 · Discontinued | $56.23 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $218.78 | Professional | 54 · Surgery only | $208.93 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $43.65 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $29.51 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $75.86 Typical High $213.80 | Professional | 51 · Multiple procedures | $74.13 | $75.86 | $213.80 |
Where South Carolina sits
The same service costs 8.3 times more in Oklahoma than in Rhode Island. 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· 30th of 51
$389
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.