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 $549.54 Median $9,120.11 Typical High $22,908.68 | Facility | None | $549.54 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $549.54 | Professional | None | $389.05 | $549.54 | $549.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $239.88 | Professional | None | $204.17 | $204.17 | $239.88 |
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 $467.74 Median $660.69 Typical High $1,148.15 | Professional | None | $467.74 | $660.69 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $602.56 Typical High $741.31 | Facility | None | $549.54 | $602.56 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $562.34 | Professional | None | $338.84 | $524.81 | $562.34 |
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 $194.98 Median $407.38 Typical High $676.08 | Professional | None | $194.98 | $407.38 | $676.08 |
3 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 54 · Surgery only Typical Low $295.12 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $295.12 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $58.88 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.90 | $54.95 | $54.95 |
Where South Carolina sits
The same service costs 7.1 times more in Wisconsin than in New York. 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· 44th of 51
$537
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.