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 $50.12 Median $50.12 Typical High $97.72 | Facility | None | $50.12 | $50.12 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $66.07 Typical High $97.72 | Professional | None | $50.12 | $66.07 | $97.72 |
BCBS South Carolina Setting Facility Modifier None Typical Low $169.82 Median $295.12 Typical High $512.86 | Facility | None | $169.82 | $295.12 | $512.86 |
BCBS South Carolina Setting Professional Modifier None Typical Low $37.15 Median $48.98 Typical High $91.20 | Professional | None | $37.15 | $48.98 | $91.20 |
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 $51.29 Median $89.13 Typical High $128.82 | Professional | None | $51.29 | $89.13 | $128.82 |
Medcost Setting Facility Modifier None Typical Low $50.12 Median $91.20 Typical High $120.23 | Facility | None | $50.12 | $91.20 | $120.23 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $112.20 | Professional | None | $83.18 | $97.72 | $112.20 |
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 $38.90 Median $69.18 Typical High $117.49 | Professional | None | $38.90 | $69.18 | $117.49 |
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 $25.12 Median $33.11 Typical High $48.98 | Professional | 52 · Reduced service | $25.12 | $33.11 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $13.49 Typical High $19.50 | Professional | 53 · Discontinued | $10.00 | $13.49 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $10.00 Typical High $14.45 | Professional | 55 · Aftercare only | $7.41 | $10.00 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.61 Typical High $9.77 | Professional | 56 · Pre-op care only | $5.01 | $6.61 | $9.77 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $41.69 Median $51.29 Typical High $75.86 | Professional | 51 · Multiple procedures | $41.69 | $51.29 | $75.86 |
Where South Carolina sits
The same service costs 3.9 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· 18th of 51
$89.13
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.