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 $407.38 Median $12,589.25 Typical High $21,877.62 | Facility | None | $407.38 | $12,589.25 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $562.34 | Professional | None | $407.38 | $407.38 | $562.34 |
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 $16,218.10 Typical High $22,908.68 | Facility | None | $602.56 | $16,218.10 | $22,908.68 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $489.78 Typical High $13,803.84 | Facility | None | $407.38 | $489.78 | $13,803.84 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $416.87 Typical High $851.14 | Professional | None | $407.38 | $416.87 | $851.14 |
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 $575.44 Median $891.25 Typical High $1,258.93 | Professional | None | $575.44 | $891.25 | $1,258.93 |
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 $204.17 Median $204.17 Typical High $229.09 | Professional | 52 · Reduced service | $204.17 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $93.33 | Professional | 53 · Discontinued | $81.28 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $346.74 | Professional | 54 · Surgery only | $302.00 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $69.18 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $45.71 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $45.71 |
Where South Carolina sits
The same service costs 27.5 times more in Oklahoma than in New York. 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· 19th 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.