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 $15.85 Median $4,897.79 Typical High $21,877.62 | Facility | None | $15.85 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $28.84 Typical High $46.77 | Professional | None | $15.85 | $28.84 | $46.77 |
Ambetter Setting Professional Modifier None Typical Low $22.91 Median $42.66 Typical High $46.77 | Professional | None | $22.91 | $42.66 | $46.77 |
BCBS South Carolina Setting Facility Modifier None Typical Low $134.90 Median $223.87 Typical High $398.11 | Facility | None | $134.90 | $223.87 | $398.11 |
BCBS South Carolina Setting Professional Modifier None Typical Low $20.89 Median $42.66 Typical High $54.95 | Professional | None | $20.89 | $42.66 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $794.33 | Facility | None | $52.48 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $38.02 Typical High $57.54 | Professional | None | $26.30 | $38.02 | $57.54 |
Medcost Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Medcost Setting Facility Modifier None Typical Low $17.38 Median $35.48 Typical High $42.66 | Facility | None | $17.38 | $35.48 | $42.66 |
Medcost Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $81.28 | Professional | None | $41.69 | $50.12 | $81.28 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $114.82 | Professional | None | $64.57 | $79.43 | $114.82 |
United Setting Facility Modifier None Typical Low $83.18 Median $380.19 Typical High $2,238.72 | Facility | None | $83.18 | $380.19 | $2,238.72 |
United Setting Professional Modifier None Typical Low $21.88 Median $37.15 Typical High $63.10 | Professional | None | $21.88 | $37.15 | $63.10 |
6 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 $7.94 Median $11.48 Typical High $14.45 | Professional | 52 · Reduced service | $7.94 | $11.48 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $4.57 Typical High $5.75 | Professional | 53 · Discontinued | $3.16 | $4.57 | $5.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.02 Median $16.98 Typical High $21.88 | Professional | 54 · Surgery only | $12.02 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $3.39 Typical High $4.37 | Professional | 55 · Aftercare only | $2.40 | $3.39 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $2.29 Typical High $2.88 | Professional | 56 · Pre-op care only | $1.58 | $2.29 | $2.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $20.89 Median $26.92 Typical High $40.74 | Professional | 51 · Multiple procedures | $20.89 | $26.92 | $40.74 |
Where South Carolina sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 28th of 51
$44.67
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.