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 $102.33 Median $5,248.07 Typical High $16,595.87 | Facility | None | $102.33 | $5,248.07 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $194.98 | Professional | None | $102.33 | $134.90 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
BCBS South Carolina Setting Facility Modifier None Typical Low $562.34 Median $870.96 Typical High $1,348.96 | Facility | None | $562.34 | $870.96 | $1,348.96 |
BCBS South Carolina Setting Professional Modifier None Typical Low $81.28 Median $151.36 Typical High $194.98 | Professional | None | $81.28 | $151.36 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $288.40 Typical High $794.33 | Facility | None | $107.15 | $288.40 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $199.53 | Professional | None | $109.65 | $158.49 | $199.53 |
Medcost Setting Facility Modifier None Typical Low $102.33 Median $177.83 Typical High $257.04 | Facility | None | $102.33 | $177.83 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $199.53 | Professional | None | $181.97 | $199.53 | $199.53 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $288.40 | Professional | None | $158.49 | $194.98 | $288.40 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $251.19 | Professional | None | $85.11 | $131.83 | $251.19 |
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 $51.29 Median $51.29 Typical High $85.11 | Professional | 52 · Reduced service | $51.29 | $51.29 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $34.67 | Professional | 53 · Discontinued | $20.42 | $20.42 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $128.82 | Professional | 54 · Surgery only | $75.86 | $75.86 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $25.70 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $16.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $100.00 Median $100.00 Typical High $112.20 | Professional | 51 · Multiple procedures | $100.00 | $100.00 | $112.20 |
Where South Carolina sits
The same service costs 3.2 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· 20th of 51
$174
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.