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 $331.13 Median $10,964.78 Typical High $21,877.62 | Facility | None | $331.13 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $380.19 | Professional | None | $331.13 | $331.13 | $380.19 |
BCBS South Carolina Setting Facility Modifier None Typical Low $645.65 Median $870.96 Typical High $1,230.27 | Facility | None | $645.65 | $870.96 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $8,511.38 Typical High $12,022.64 | Facility | None | $602.56 | $8,511.38 | $12,022.64 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $398.11 Typical High $8,912.51 | Facility | None | $331.13 | $398.11 | $8,912.51 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $338.84 Typical High $575.44 | Professional | None | $331.13 | $338.84 | $575.44 |
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 $398.11 Median $602.56 Typical High $954.99 | Professional | None | $398.11 | $602.56 | $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 $165.96 Median $165.96 Typical High $177.83 | Professional | 52 · Reduced service | $165.96 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $70.79 | Professional | 53 · Discontinued | $66.07 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $269.15 | Professional | 54 · Surgery only | $245.47 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $53.70 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $35.48 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $35.48 |
Where South Carolina sits
The same service costs 32.4 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· 32nd of 51
$871
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.