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 $5,888.44 Typical High $21,877.62 | Facility | None | $331.13 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $346.74 | Professional | None | $331.13 | $331.13 | $346.74 |
BCBS South Carolina Setting Facility Modifier None Typical Low $660.69 Median $870.96 Typical High $4,365.16 | Facility | None | $660.69 | $870.96 | $4,365.16 |
BCBS South Carolina Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $724.44 | Professional | None | $630.96 | $630.96 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,691.53 Typical High $4,265.80 | Facility | None | $602.56 | $2,691.53 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $363.08 Typical High $2,818.38 | Facility | None | $331.13 | $363.08 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $467.74 | Professional | None | $331.13 | $331.13 | $467.74 |
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 $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $691.83 | Professional | None | $302.00 | $398.11 | $691.83 |
7 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 $173.78 | Professional | 52 · Reduced service | $165.96 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $69.18 | Professional | 53 · Discontinued | $66.07 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $263.03 | Professional | 54 · Surgery only | $251.19 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $52.48 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $34.67 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $34.67 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $501.19 Typical High $933.25 | Professional | 50 · Both sides | $501.19 | $501.19 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $165.96 Typical High $309.03 | Professional | 51 · Multiple procedures | $165.96 | $165.96 | $309.03 |
Where South Carolina sits
The same service costs 28.2 times more in Texas than in Kentucky. 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· 16th of 51
$631
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.