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 $46.77 Median $4,897.79 Typical High $21,877.62 | Facility | None | $46.77 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $64.57 Typical High $87.10 | Professional | None | $46.77 | $64.57 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $75.86 | Professional | None | $38.90 | $38.90 | $75.86 |
BCBS South Carolina Setting Facility Modifier None Typical Low $389.05 Median $676.08 Typical High $1,174.90 | Facility | None | $389.05 | $676.08 | $1,174.90 |
BCBS South Carolina Setting Professional Modifier None Typical Low $35.48 Median $46.77 Typical High $74.13 | Professional | None | $35.48 | $46.77 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $128.82 Typical High $707.95 | Facility | None | $47.86 | $128.82 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $100.00 | Professional | None | $50.12 | $67.61 | $100.00 |
Medcost Setting Facility Modifier None Typical Low $38.90 Median $58.88 Typical High $79.43 | Facility | None | $38.90 | $58.88 | $79.43 |
Medcost Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $87.10 | Professional | None | $69.18 | $81.28 | $87.10 |
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 $36.31 Median $56.23 Typical High $95.50 | Professional | None | $36.31 | $56.23 | $95.50 |
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 $23.44 Median $25.70 Typical High $36.31 | Professional | 52 · Reduced service | $23.44 | $25.70 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.47 Typical High $14.45 | Professional | 53 · Discontinued | $9.33 | $10.47 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $38.90 Typical High $54.95 | Professional | 54 · Surgery only | $35.48 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.76 Typical High $10.96 | Professional | 55 · Aftercare only | $7.08 | $7.76 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.25 Typical High $7.24 | Professional | 56 · Pre-op care only | $4.68 | $5.25 | $7.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $34.67 Median $40.74 Typical High $56.23 | Professional | 51 · Multiple procedures | $34.67 | $40.74 | $56.23 |
Where South Carolina sits
The same service costs 3.5 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· 31st 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.