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 $74.13 Median $4,365.16 Typical High $16,595.87 | Facility | None | $74.13 | $4,365.16 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $138.04 Typical High $162.18 | Professional | None | $69.18 | $138.04 | $162.18 |
BCBS South Carolina Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $1,862.09 | Facility | None | $501.19 | $794.33 | $1,862.09 |
BCBS South Carolina Setting Professional Modifier None Typical Low $58.88 Median $104.71 Typical High $177.83 | Professional | None | $58.88 | $104.71 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $812.83 Typical High $1,348.96 | Facility | None | $457.09 | $812.83 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $144.54 Typical High $245.47 | Professional | None | $72.44 | $144.54 | $245.47 |
Medcost Setting Facility Modifier None Typical Low $74.13 Median $218.78 Typical High $630.96 | Facility | None | $74.13 | $218.78 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $218.78 | Professional | None | $141.25 | $165.96 | $218.78 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $251.19 | Professional | None | $128.82 | $181.97 | $251.19 |
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 $67.61 Median $138.04 Typical High $239.88 | Professional | None | $67.61 | $138.04 | $239.88 |
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 $35.48 Median $38.02 Typical High $81.28 | Professional | 52 · Reduced service | $35.48 | $38.02 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $15.14 Typical High $32.36 | Professional | 53 · Discontinued | $14.13 | $15.14 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $56.23 Typical High $120.23 | Professional | 54 · Surgery only | $52.48 | $56.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $11.22 Typical High $24.55 | Professional | 55 · Aftercare only | $10.47 | $11.22 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.59 Typical High $16.22 | Professional | 56 · Pre-op care only | $7.08 | $7.59 | $16.22 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $251.19 Typical High $398.11 | Professional | 50 · Both sides | $208.93 | $251.19 | $398.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $70.79 Median $83.18 Typical High $131.83 | Professional | 51 · Multiple procedures | $70.79 | $83.18 | $131.83 |
Where South Carolina sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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
$166
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.