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 $61.66 Median $61.66 Typical High $85.11 | Facility | None | $61.66 | $61.66 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $102.33 | Professional | None | $61.66 | $81.28 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
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 $48.98 Median $95.50 Typical High $109.65 | Professional | None | $48.98 | $95.50 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $72.44 Typical High $151.36 | Facility | None | $57.54 | $72.44 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $97.72 Typical High $128.82 | Professional | None | $77.62 | $97.72 | $128.82 |
Medcost Setting Facility Modifier None Typical Low $61.66 Median $85.11 Typical High $104.71 | Facility | None | $61.66 | $85.11 | $104.71 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $128.82 | Professional | None | $85.11 | $109.65 | $128.82 |
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 $48.98 Median $75.86 Typical High $134.90 | Professional | None | $48.98 | $75.86 | $134.90 |
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 $30.90 Median $33.11 Typical High $42.66 | Professional | 52 · Reduced service | $30.90 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.18 Typical High $16.98 | Professional | 53 · Discontinued | $12.30 | $13.18 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.00 Typical High $12.88 | Professional | 55 · Aftercare only | $9.33 | $10.00 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.61 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.17 | $6.61 | $8.51 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $151.36 Median $165.96 Typical High $204.17 | Professional | 50 · Both sides | $151.36 | $165.96 | $204.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $50.12 Median $54.95 Typical High $69.18 | Professional | 51 · Multiple procedures | $50.12 | $54.95 | $69.18 |
Where South Carolina sits
The same service costs 3.5 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· 18th of 51
$95.50
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.