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 $1,380.38 Median $12,882.50 Typical High $21,877.62 | Facility | None | $1,380.38 | $12,882.50 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,258.93 | $1,380.38 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
BCBS South Carolina Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $10,964.78 | Facility | None | $501.19 | $794.33 | $10,964.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $354.81 Median $1,412.54 Typical High $1,445.44 | Professional | None | $354.81 | $1,412.54 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,128.61 Typical High $11,481.54 | Facility | None | $602.56 | $5,128.61 | $11,481.54 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $6,456.54 | Facility | None | $1,380.38 | $1,659.59 | $6,456.54 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,137.96 | Professional | None | $1,479.11 | $1,479.11 | $2,137.96 |
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 $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $2,041.74 Typical High $3,388.44 | Professional | None | $1,258.93 | $2,041.74 | $3,388.44 |
4 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 $630.96 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $630.96 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $251.19 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $186.21 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $125.89 | $138.04 | $138.04 |
Where South Carolina sits
The same service costs 9.1 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· 47th of 51
$1,445
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.