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 $20.42 Median $20.42 Typical High $32.36 | Facility | None | $20.42 | $20.42 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $29.51 Typical High $42.66 | Professional | None | $20.42 | $29.51 | $42.66 |
Ambetter Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $39.81 | Professional | None | $26.92 | $26.92 | $39.81 |
BCBS South Carolina Setting Facility Modifier None Typical Low $169.82 Median $288.40 Typical High $501.19 | Facility | None | $169.82 | $288.40 | $501.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $15.14 Median $36.31 Typical High $46.77 | Professional | None | $15.14 | $36.31 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $26.30 Typical High $131.83 | Facility | None | $16.22 | $26.30 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $39.81 Typical High $50.12 | Professional | None | $27.54 | $39.81 | $50.12 |
Medcost Setting Facility Modifier None Typical Low $22.39 Median $33.88 Typical High $42.66 | Facility | None | $22.39 | $33.88 | $42.66 |
Medcost Setting Professional Modifier None Typical Low $32.36 Median $45.71 Typical High $53.70 | Professional | None | $32.36 | $45.71 | $53.70 |
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 $15.49 Median $28.18 Typical High $54.95 | Professional | None | $15.49 | $28.18 | $54.95 |
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 $10.23 Median $11.75 Typical High $16.22 | Professional | 52 · Reduced service | $10.23 | $11.75 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.79 Typical High $6.46 | Professional | 53 · Discontinued | $4.07 | $4.79 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.55 Typical High $4.79 | Professional | 55 · Aftercare only | $3.09 | $3.55 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.34 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.04 | $2.34 | $3.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $56.23 Median $75.86 Typical High $81.28 | Professional | 50 · Both sides | $56.23 | $75.86 | $81.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $18.62 Median $25.12 Typical High $26.92 | Professional | 51 · Multiple procedures | $18.62 | $25.12 | $26.92 |
Where South Carolina sits
The same service costs 3.0 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
$36.31
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.