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 $380.19 Median $10,964.78 Typical High $21,877.62 | Facility | None | $380.19 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $398.11 | Professional | None | $380.19 | $380.19 | $398.11 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,698.24 Median $2,951.21 Typical High $3,467.37 | Facility | None | $1,698.24 | $2,951.21 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $8,128.31 Typical High $11,481.54 | Facility | None | $602.56 | $8,128.31 | $11,481.54 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $416.87 Typical High $8,912.51 | Facility | None | $309.03 | $416.87 | $8,912.51 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $309.03 Typical High $537.03 | Professional | None | $302.00 | $309.03 | $537.03 |
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 $3,311.31 Median $11,220.18 Typical High $33,884.42 | Facility | None | $3,311.31 | $11,220.18 | $33,884.42 |
United Setting Professional Modifier None Typical Low $302.00 Median $501.19 Typical High $812.83 | Professional | None | $302.00 | $501.19 | $812.83 |
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 $190.55 Median $190.55 Typical High $199.53 | Professional | 52 · Reduced service | $190.55 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $79.43 | Professional | 53 · Discontinued | $75.86 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $295.12 | Professional | 54 · Surgery only | $281.84 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $39.81 |
Where South Carolina sits
The same service costs 16.2 times more in Arkansas than in West 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· 14th of 51
$2,239
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.