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 $128.82 Median $128.82 Typical High $165.96 | Facility | None | $128.82 | $128.82 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $165.96 | Professional | None | $123.03 | $134.90 | $165.96 |
BCBS South Carolina Setting Facility Modifier None Typical Low $165.96 Median $295.12 Typical High $512.86 | Facility | None | $165.96 | $295.12 | $512.86 |
BCBS South Carolina Setting Professional Modifier None Typical Low $53.70 Median $138.04 Typical High $169.82 | Professional | None | $53.70 | $138.04 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $85.11 Typical High $151.36 | Facility | None | $75.86 | $85.11 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $239.88 | Professional | None | $144.54 | $173.78 | $239.88 |
Medcost Setting Facility Modifier None Typical Low $67.61 Median $117.49 Typical High $181.97 | Facility | None | $67.61 | $117.49 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $204.17 | Professional | None | $141.25 | $177.83 | $204.17 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $234.42 | Professional | None | $131.83 | $158.49 | $234.42 |
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 $100.00 Median $141.25 Typical High $239.88 | Professional | None | $100.00 | $141.25 | $239.88 |
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 $64.57 Median $64.57 Typical High $83.18 | Professional | 52 · Reduced service | $64.57 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.30 Typical High $33.11 | Professional | 53 · Discontinued | $25.70 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $25.12 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.18 Typical High $16.60 | Professional | 56 · Pre-op care only | $12.88 | $13.18 | $16.60 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $223.87 Median $309.03 Typical High $389.05 | Professional | 50 · Both sides | $223.87 | $309.03 | $389.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $102.33 Typical High $128.82 | Professional | 51 · Multiple procedures | $74.13 | $102.33 | $128.82 |
Where South Carolina sits
The same service costs 4.3 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· 33rd of 51
$151
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.