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 $457.09 Median $10,964.78 Typical High $21,877.62 | Facility | None | $457.09 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $478.63 | Professional | None | $457.09 | $457.09 | $478.63 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,311.31 Median $6,309.57 Typical High $7,079.46 | Facility | None | $3,311.31 | $6,309.57 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $20,417.38 Typical High $28,840.32 | Facility | None | $602.56 | $20,417.38 | $28,840.32 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $501.19 Typical High $33,113.11 | Facility | None | $457.09 | $501.19 | $33,113.11 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $758.58 | Professional | None | $478.63 | $489.78 | $758.58 |
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 $4,365.16 Median $28,840.32 Typical High $69,183.10 | Facility | None | $4,365.16 | $28,840.32 | $69,183.10 |
United Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $1,202.26 | Professional | None | $478.63 | $724.44 | $1,202.26 |
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 $223.87 Median $223.87 Typical High $234.42 | Professional | 52 · Reduced service | $223.87 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $95.50 | Professional | 53 · Discontinued | $91.20 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $354.81 | Professional | 54 · Surgery only | $338.84 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $47.86 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $47.86 |
Where South Carolina sits
The same service costs 29.5 times more in Louisiana than in Maine. 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
$4,074
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.