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 $45.71 Median $67.61 Typical High $117.49 | Facility | None | $45.71 | $67.61 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $63.10 Typical High $87.10 | Professional | None | $45.71 | $63.10 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $114.82 | Professional | None | $42.66 | $61.66 | $114.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $128.82 Median $263.03 Typical High $478.63 | Facility | None | $128.82 | $263.03 | $478.63 |
BCBS South Carolina Setting Professional Modifier None Typical Low $37.15 Median $42.66 Typical High $74.13 | Professional | None | $37.15 | $42.66 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $794.33 | Facility | None | $52.48 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $75.86 Typical High $102.33 | Professional | None | $47.86 | $75.86 | $102.33 |
Medcost Setting Facility Modifier None Typical Low $44.67 Median $75.86 Typical High $83.18 | Facility | None | $44.67 | $75.86 | $83.18 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $77.62 Typical High $97.72 | Professional | None | $64.57 | $77.62 | $97.72 |
Molina Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $112.20 | Professional | None | $61.66 | $77.62 | $112.20 |
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 $34.67 Median $56.23 Typical High $97.72 | Professional | None | $34.67 | $56.23 | $97.72 |
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 $22.91 Median $27.54 Typical High $37.15 | Professional | 52 · Reduced service | $22.91 | $27.54 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $10.96 Typical High $15.14 | Professional | 53 · Discontinued | $9.12 | $10.96 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $8.32 Typical High $11.22 | Professional | 55 · Aftercare only | $6.92 | $8.32 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.50 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.57 | $5.50 | $7.59 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $95.50 Median $131.83 Typical High $173.78 | Professional | 50 · Both sides | $95.50 | $131.83 | $173.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $32.36 Median $45.71 Typical High $57.54 | Professional | 51 · Multiple procedures | $32.36 | $45.71 | $57.54 |
Where South Carolina sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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
$67.61
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.