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 $69.18 Median $234.42 Typical High $10,000.00 | Facility | None | $69.18 | $234.42 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $186.21 | Professional | None | $66.07 | $102.33 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $177.83 | Professional | None | $89.13 | $89.13 | $177.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $162.18 Median $281.84 Typical High $512.86 | Facility | None | $162.18 | $281.84 | $512.86 |
BCBS South Carolina Setting Professional Modifier None Typical Low $47.86 Median $93.33 Typical High $154.88 | Professional | None | $47.86 | $93.33 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $794.33 | Facility | None | $52.48 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $109.65 Typical High $251.19 | Professional | None | $66.07 | $109.65 | $251.19 |
Medcost Setting Facility Modifier None Typical Low $47.86 Median $74.13 Typical High $186.21 | Facility | None | $47.86 | $74.13 | $186.21 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $208.93 | Professional | None | $114.82 | $147.91 | $208.93 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $316.23 | Professional | None | $158.49 | $229.09 | $316.23 |
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 $54.95 Median $109.65 Typical High $208.93 | Professional | None | $54.95 | $109.65 | $208.93 |
7 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 $33.88 Median $35.48 Typical High $93.33 | Professional | 52 · Reduced service | $33.88 | $35.48 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.13 Typical High $37.15 | Professional | 53 · Discontinued | $13.49 | $14.13 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $52.48 Typical High $141.25 | Professional | 54 · Surgery only | $51.29 | $52.48 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.47 Typical High $28.18 | Professional | 55 · Aftercare only | $10.23 | $10.47 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.08 Typical High $18.62 | Professional | 56 · Pre-op care only | $6.76 | $7.08 | $18.62 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $223.87 Typical High $407.38 | Professional | 50 · Both sides | $173.78 | $223.87 | $407.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $74.13 Typical High $123.03 | Professional | 51 · Multiple procedures | $57.54 | $74.13 | $123.03 |
Where South Carolina sits
The same service costs 4.0 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· 12th of 51
$155
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.