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 $83.18 Median $4,897.79 Typical High $21,877.62 | Facility | None | $83.18 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $128.82 Typical High $177.83 | Professional | None | $75.86 | $128.82 | $177.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $63.10 Median $112.20 Typical High $426.58 | Professional | None | $63.10 | $112.20 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $181.97 Typical High $288.40 | Professional | None | $87.10 | $181.97 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $173.78 Typical High $239.88 | Facility | None | $83.18 | $173.78 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $199.53 Typical High $338.84 | Professional | None | $162.18 | $199.53 | $338.84 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $251.19 | Professional | None | $131.83 | $173.78 | $251.19 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $2,951.21 | Facility | None | $446.68 | $1,621.81 | $2,951.21 |
United Setting Professional Modifier None Typical Low $75.86 Median $162.18 Typical High $281.84 | Professional | None | $75.86 | $162.18 | $281.84 |
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 $37.15 Median $64.57 Typical High $89.13 | Professional | 52 · Reduced service | $37.15 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $25.70 Typical High $35.48 | Professional | 53 · Discontinued | $14.79 | $25.70 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $97.72 Typical High $134.90 | Professional | 54 · Surgery only | $54.95 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $19.50 Typical High $26.92 | Professional | 55 · Aftercare only | $11.22 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $12.88 Typical High $17.78 | Professional | 56 · Pre-op care only | $7.41 | $12.88 | $17.78 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $263.03 Median $309.03 Typical High $724.44 | Professional | 50 · Both sides | $263.03 | $309.03 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $87.10 Median $102.33 Typical High $239.88 | Professional | 51 · Multiple procedures | $87.10 | $102.33 | $239.88 |
Where South Carolina sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 29th of 51
$155
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.