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 $21.88 Median $21.88 Typical High $37.15 | Facility | None | $21.88 | $21.88 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $32.36 Typical High $37.15 | Professional | None | $21.88 | $32.36 | $37.15 |
BCBS South Carolina Setting Facility Modifier None Typical Low $169.82 Median $288.40 Typical High $512.86 | Facility | None | $169.82 | $288.40 | $512.86 |
BCBS South Carolina Setting Professional Modifier None Typical Low $15.14 Median $37.15 Typical High $45.71 | Professional | None | $15.14 | $37.15 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $33.88 Typical High $131.83 | Facility | None | $20.89 | $33.88 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $46.77 Typical High $67.61 | Professional | None | $29.51 | $46.77 | $67.61 |
Medcost Setting Facility Modifier None Typical Low $29.51 Median $45.71 Typical High $51.29 | Facility | None | $29.51 | $45.71 | $51.29 |
Medcost Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $81.28 | Professional | None | $37.15 | $53.70 | $81.28 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $38.90 Typical High $56.23 | Professional | None | $30.90 | $38.90 | $56.23 |
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 $16.60 Median $33.88 Typical High $70.79 | Professional | None | $16.60 | $33.88 | $70.79 |
5 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 $10.72 Median $14.13 Typical High $18.62 | Professional | 52 · Reduced service | $10.72 | $14.13 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $5.75 Typical High $7.41 | Professional | 53 · Discontinued | $4.37 | $5.75 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $4.27 Typical High $5.62 | Professional | 55 · Aftercare only | $3.24 | $4.27 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.82 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.14 | $2.82 | $3.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $23.44 Median $31.62 Typical High $40.74 | Professional | 51 · Multiple procedures | $23.44 | $31.62 | $40.74 |
Where South Carolina sits
The same service costs 3.5 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· 15th of 51
$43.65
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.