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 $2.24 Median $4,365.16 Typical High $16,595.87 | Facility | None | $2.24 | $4,365.16 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $2.24 Median $6.61 Typical High $10.72 | Professional | None | $2.24 | $6.61 | $10.72 |
Ambetter Setting Professional Modifier None Typical Low $1.82 Median $5.13 Typical High $7.24 | Professional | None | $1.82 | $5.13 | $7.24 |
BCBS South Carolina Setting Facility Modifier None Typical Low $66.07 Median $138.04 Typical High $213.80 | Facility | None | $66.07 | $138.04 | $213.80 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1.62 Median $8.91 Typical High $15.85 | Professional | None | $1.62 | $8.91 | $15.85 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $891.25 Typical High $1,995.26 | Facility | None | $100.00 | $891.25 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $2.69 Median $5.75 Typical High $11.75 | Professional | None | $2.69 | $5.75 | $11.75 |
Medcost Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Medcost Setting Facility Modifier None Typical Low $2.45 Median $6.92 Typical High $9.33 | Facility | None | $2.45 | $6.92 | $9.33 |
Medcost Setting Professional Modifier None Typical Low $7.59 Median $8.71 Typical High $16.60 | Professional | None | $7.59 | $8.71 | $16.60 |
United Setting Facility Modifier None Typical Low $83.18 Median $426.58 Typical High $2,238.72 | Facility | None | $83.18 | $426.58 | $2,238.72 |
United Setting Professional Modifier None Typical Low $1.95 Median $5.25 Typical High $9.33 | Professional | None | $1.95 | $5.25 | $9.33 |
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 $1.12 Median $2.00 Typical High $3.55 | Professional | 52 · Reduced service | $1.12 | $2.00 | $3.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.45 Median $0.79 Typical High $1.45 | Professional | 53 · Discontinued | $0.45 | $0.79 | $1.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.70 Median $2.95 Typical High $5.37 | Professional | 54 · Surgery only | $1.70 | $2.95 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.34 Median $0.60 Typical High $1.07 | Professional | 55 · Aftercare only | $0.34 | $0.60 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.40 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.23 | $0.40 | $0.72 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $4.57 Median $5.37 Typical High $10.96 | Professional | 59 · Distinct service | $4.57 | $5.37 | $10.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $4.37 Median $4.68 Typical High $8.13 | Professional | 51 · Multiple procedures | $4.37 | $4.68 | $8.13 |
Where South Carolina sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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· 9th of 51
$7.94
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.