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 $61.66 Median $4,897.79 Typical High $21,877.62 | Facility | None | $61.66 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $107.15 | Professional | None | $61.66 | $91.20 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $131.83 | Professional | None | $77.62 | $93.33 | $131.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $102.33 Median $173.78 Typical High $309.03 | Facility | None | $102.33 | $173.78 | $309.03 |
BCBS South Carolina Setting Professional Modifier None Typical Low $46.77 Median $104.71 Typical High $123.03 | Professional | None | $46.77 | $104.71 | $123.03 |
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 $72.44 Median $93.33 Typical High $134.90 | Professional | None | $72.44 | $93.33 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $30.20 Median $61.66 Typical High $114.82 | Facility | None | $30.20 | $61.66 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $134.90 | Professional | None | $107.15 | $107.15 | $134.90 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $169.82 | Professional | None | $95.50 | $117.49 | $169.82 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $48.98 Median $85.11 Typical High $158.49 | Professional | None | $48.98 | $85.11 | $158.49 |
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 $30.90 Median $35.48 Typical High $51.29 | Professional | 52 · Reduced service | $30.90 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $14.45 Typical High $20.42 | Professional | 53 · Discontinued | $12.30 | $14.45 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $53.70 Typical High $75.86 | Professional | 54 · Surgery only | $45.71 | $53.70 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.72 Typical High $15.14 | Professional | 55 · Aftercare only | $9.12 | $10.72 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.08 Typical High $10.23 | Professional | 56 · Pre-op care only | $6.17 | $7.08 | $10.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $53.70 Median $63.10 Typical High $67.61 | Professional | 51 · Multiple procedures | $53.70 | $63.10 | $67.61 |
Where South Carolina sits
The same service costs 3.2 times more in Alaska 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· 25th of 51
$102
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.