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 $1,000.00 Median $12,589.25 Typical High $21,877.62 | Facility | None | $1,000.00 | $12,589.25 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,047.13 | Professional | None | $1,000.00 | $1,000.00 | $1,047.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,388.44 Median $6,918.31 Typical High $23,988.33 | Facility | None | $3,388.44 | $6,918.31 | $23,988.33 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $891.25 Typical High $16,595.87 | Facility | None | $588.84 | $891.25 | $16,595.87 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $19,054.61 | Facility | None | $1,000.00 | $1,202.26 | $19,054.61 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,071.52 | $1,548.82 |
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 $1,071.52 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,071.52 | $1,621.81 | $2,691.53 |
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 $501.19 Median $501.19 Typical High $524.81 | Professional | 52 · Reduced service | $501.19 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $208.93 | Professional | 53 · Discontinued | $199.53 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $158.49 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $104.71 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $104.71 |
Where South Carolina sits
The same service costs 18.2 times more in California 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· 8th of 51
$4,266
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.