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 $758.58 Median $10,964.78 Typical High $21,877.62 | Facility | None | $758.58 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $758.58 | Professional | None | $707.95 | $758.58 | $758.58 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,311.31 Median $5,495.41 Typical High $6,918.31 | Facility | None | $3,311.31 | $5,495.41 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,623.41 Typical High $7,943.28 | Facility | None | $602.56 | $5,623.41 | $7,943.28 |
Medcost Setting Facility Modifier None Typical Low $338.84 Median $831.76 Typical High $5,011.87 | Facility | None | $338.84 | $831.76 | $5,011.87 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $338.84 Typical High $1,023.29 | Professional | None | $331.13 | $338.84 | $1,023.29 |
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 $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $331.13 Median $575.44 Typical High $954.99 | Professional | None | $331.13 | $575.44 | $954.99 |
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 $354.81 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $354.81 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $141.25 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $524.81 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $104.71 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $70.79 | $75.86 | $75.86 |
Where South Carolina sits
The same service costs 14.8 times more in Texas 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· 4th of 51
$3,020
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.