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 $1,047.13 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,047.13 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,047.13 | Professional | None | $758.58 | $1,047.13 | $1,047.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,513.56 | Professional | None | $645.65 | $912.01 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,778.28 | Professional | None | $933.25 | $1,047.13 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,047.13 Typical High $2,089.30 | Facility | None | $794.33 | $1,047.13 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,096.48 | Professional | None | $870.96 | $1,023.29 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,318.26 | Professional | None | $676.08 | $1,000.00 | $1,318.26 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $1,905.46 | Professional | None | $758.58 | $1,148.15 | $1,905.46 |
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 $380.19 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $380.19 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $151.36 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $562.34 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $112.20 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $75.86 | $104.71 | $104.71 |
Where South Carolina sits
The same service costs 4.6 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· 37th of 51
$977
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.