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 $48.98 Median $93.33 Typical High $144.54 | Facility | None | $48.98 | $93.33 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $77.62 Typical High $107.15 | Professional | None | $48.98 | $77.62 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $57.54 | Professional | None | $39.81 | $39.81 | $57.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $154.88 Median $275.42 Typical High $478.63 | Facility | None | $154.88 | $275.42 | $478.63 |
BCBS South Carolina Setting Professional Modifier None Typical Low $36.31 Median $61.66 Typical High $95.50 | Professional | None | $36.31 | $61.66 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $79.43 Typical High $151.36 | Facility | None | $72.44 | $79.43 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $128.82 | Professional | None | $64.57 | $97.72 | $128.82 |
Medcost Setting Facility Modifier None Typical Low $51.29 Median $91.20 Typical High $114.82 | Facility | None | $51.29 | $91.20 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $125.89 | Professional | None | $93.33 | $109.65 | $125.89 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $173.78 | Professional | None | $95.50 | $117.49 | $173.78 |
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 $37.15 Median $74.13 Typical High $125.89 | Professional | None | $37.15 | $74.13 | $125.89 |
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 $23.99 Median $32.36 Typical High $46.77 | Professional | 52 · Reduced service | $23.99 | $32.36 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $13.18 Typical High $19.05 | Professional | 53 · Discontinued | $9.77 | $13.18 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $9.77 Typical High $14.13 | Professional | 55 · Aftercare only | $7.24 | $9.77 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.46 Typical High $9.33 | Professional | 56 · Pre-op care only | $4.79 | $6.46 | $9.33 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $147.91 Median $177.83 Typical High $218.78 | Professional | 50 · Both sides | $147.91 | $177.83 | $218.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $50.12 Median $58.88 Typical High $72.44 | Professional | 51 · Multiple procedures | $50.12 | $58.88 | $72.44 |
Where South Carolina sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 17th of 51
$93.33
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.