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 $316.23 Median $10,964.78 Typical High $21,877.62 | Facility | None | $316.23 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $331.13 | Professional | None | $316.23 | $316.23 | $331.13 |
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 $316.23 Median $346.74 Typical High $15,848.93 | Facility | None | $316.23 | $346.74 | $15,848.93 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $323.59 Typical High $501.19 | Professional | None | $316.23 | $323.59 | $501.19 |
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 $316.23 Median $478.63 Typical High $794.33 | Professional | None | $316.23 | $478.63 | $794.33 |
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 $158.49 Median $158.49 Typical High $165.96 | Professional | 52 · Reduced service | $158.49 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $66.07 | Professional | 53 · Discontinued | $63.10 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $251.19 | Professional | 54 · Surgery only | $239.88 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $50.12 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $33.11 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $33.11 |
Where South Carolina sits
The same service costs 15.8 times more in Arkansas 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· 16th 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.