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 $39.81 Median $117.49 Typical High $16,595.87 | Facility | None | $39.81 | $117.49 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $64.57 Typical High $100.00 | Professional | None | $39.81 | $64.57 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $42.66 Median $60.26 Typical High $154.88 | Professional | None | $42.66 | $60.26 | $154.88 |
BCBS South Carolina Setting Facility Modifier None Typical Low $234.42 Median $380.19 Typical High $676.08 | Facility | None | $234.42 | $380.19 | $676.08 |
BCBS South Carolina Setting Professional Modifier None Typical Low $30.20 Median $37.15 Typical High $85.11 | Professional | None | $30.20 | $37.15 | $85.11 |
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 $31.62 Median $64.57 Typical High $107.15 | Professional | None | $31.62 | $64.57 | $107.15 |
Medcost Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Medcost Setting Facility Modifier None Typical Low $39.81 Median $93.33 Typical High $102.33 | Facility | None | $39.81 | $93.33 | $102.33 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $97.72 | Professional | None | $52.48 | $81.28 | $97.72 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $112.20 | Professional | None | $60.26 | $75.86 | $112.20 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $30.90 Median $61.66 Typical High $112.20 | Professional | None | $30.90 | $61.66 | $112.20 |
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 $19.95 Median $19.95 Typical High $46.77 | Professional | 52 · Reduced service | $19.95 | $19.95 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $18.62 | Professional | 53 · Discontinued | $8.13 | $8.13 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $30.20 Typical High $70.79 | Professional | 54 · Surgery only | $30.20 | $30.20 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $14.13 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $9.33 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $9.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.30 Median $39.81 Typical High $61.66 | Professional | 51 · Multiple procedures | $26.30 | $39.81 | $61.66 |
Where South Carolina sits
The same service costs 3.7 times more in Alaska 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· 46th of 51
$64.57
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.