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 $40.74 Median $4,265.80 Typical High $16,595.87 | Facility | None | $40.74 | $4,265.80 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $56.23 Typical High $77.62 | Professional | None | $40.74 | $56.23 | $77.62 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $97.72 | Professional | None | $50.12 | $63.10 | $97.72 |
BCBS South Carolina Setting Facility Modifier None Typical Low $371.54 Median $676.08 Typical High $1,230.27 | Facility | None | $371.54 | $676.08 | $1,230.27 |
BCBS South Carolina Setting Professional Modifier None Typical Low $30.20 Median $45.71 Typical High $66.07 | Professional | None | $30.20 | $45.71 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $79.43 Typical High $707.95 | Facility | None | $36.31 | $79.43 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $81.28 | Professional | None | $45.71 | $60.26 | $81.28 |
Medcost Setting Facility Modifier None Typical Low $28.84 Median $38.02 Typical High $66.07 | Facility | None | $28.84 | $38.02 | $66.07 |
Medcost Setting Professional Modifier None Typical Low $54.95 Median $64.57 Typical High $100.00 | Professional | None | $54.95 | $64.57 | $100.00 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $117.49 | Professional | None | $64.57 | $79.43 | $117.49 |
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 $31.62 Median $47.86 Typical High $83.18 | Professional | None | $31.62 | $47.86 | $83.18 |
8 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 $20.42 Median $22.39 Typical High $30.20 | Professional | 52 · Reduced service | $20.42 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.91 Typical High $12.02 | Professional | 53 · Discontinued | $8.13 | $8.91 | $12.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $33.11 Typical High $45.71 | Professional | 54 · Surgery only | $30.90 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.61 Typical High $9.12 | Professional | 55 · Aftercare only | $6.17 | $6.61 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.47 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.07 | $4.47 | $6.03 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $87.10 Median $123.03 Typical High $144.54 | Professional | 50 · Both sides | $87.10 | $123.03 | $144.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $89.13 Median $112.20 Typical High $151.36 | Professional | 50 · Both sides | $89.13 | $112.20 | $151.36 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.20 Median $38.02 Typical High $50.12 | Professional | 51 · Multiple procedures | $30.20 | $38.02 | $50.12 |
Where South Carolina sits
The same service costs 4.1 times more in Alaska than in Florida. 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· 27th of 51
$57.54
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.