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 $112.20 Median $4,897.79 Typical High $21,877.62 | Facility | None | $112.20 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $162.18 | Professional | None | $109.65 | $128.82 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $208.93 | Professional | None | $141.25 | $141.25 | $208.93 |
BCBS South Carolina Setting Facility Modifier None Typical Low $371.54 Median $660.69 Typical High $1,122.02 | Facility | None | $371.54 | $660.69 | $1,122.02 |
BCBS South Carolina Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $144.54 | Professional | None | $87.10 | $107.15 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $109.65 Typical High $173.78 | Facility | None | $75.86 | $109.65 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $218.78 | Professional | None | $117.49 | $151.36 | $218.78 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $141.25 Typical High $177.83 | Facility | None | $91.20 | $141.25 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $154.88 Typical High $181.97 | Professional | None | $134.90 | $154.88 | $181.97 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $229.09 | Professional | None | $128.82 | $154.88 | $229.09 |
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 $87.10 Median $128.82 Typical High $208.93 | Professional | None | $87.10 | $128.82 | $208.93 |
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 $56.23 Median $58.88 Typical High $77.62 | Professional | 52 · Reduced service | $56.23 | $58.88 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $23.44 Typical High $30.90 | Professional | 53 · Discontinued | $22.91 | $23.44 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.38 Typical High $22.91 | Professional | 55 · Aftercare only | $16.98 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.75 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.22 | $11.75 | $15.49 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $204.17 Median $269.15 Typical High $354.81 | Professional | 50 · Both sides | $204.17 | $269.15 | $354.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $67.61 Median $89.13 Typical High $120.23 | Professional | 51 · Multiple procedures | $67.61 | $89.13 | $120.23 |
Where South Carolina sits
The same service costs 3.7 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· 35th of 51
$141
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.