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 $446.68 Median $5,623.41 Typical High $21,877.62 | Facility | None | $446.68 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $446.68 | Professional | None | $380.19 | $446.68 | $446.68 |
BCBS South Carolina Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $741.31 | Professional | None | $549.54 | $588.84 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $1,905.46 | Facility | None | $588.84 | $851.14 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $691.83 | Professional | None | $363.08 | $467.74 | $691.83 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $446.68 Typical High $602.56 | Facility | None | $218.78 | $446.68 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $537.03 | Professional | None | $416.87 | $457.09 | $537.03 |
United Setting Facility Modifier None Typical Low $83.18 Median $426.58 Typical High $2,238.72 | Facility | None | $83.18 | $426.58 | $2,238.72 |
United Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $630.96 | Professional | None | $316.23 | $389.05 | $630.96 |
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 $190.55 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $190.55 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $75.86 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $281.84 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $57.54 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.02 | $44.67 | $44.67 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $208.93 Median $229.09 Typical High $346.74 | Professional | 51 · Multiple procedures | $208.93 | $229.09 | $346.74 |
Where South Carolina sits
The same service costs 4.6 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· 24th of 51
$525
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.