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 $645.65 Median $9,120.11 Typical High $22,908.68 | Facility | None | $645.65 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $645.65 | Professional | None | $457.09 | $645.65 | $645.65 |
BCBS South Carolina Setting Professional Modifier None Typical Low $416.87 Median $630.96 Typical High $954.99 | Professional | None | $416.87 | $630.96 | $954.99 |
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 $575.44 Median $660.69 Typical High $1,096.48 | Professional | None | $575.44 | $660.69 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $489.78 Median $645.65 Typical High $1,258.93 | Facility | None | $489.78 | $645.65 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $691.83 | Professional | None | $524.81 | $676.08 | $691.83 |
Molina Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $870.96 | Professional | None | $426.58 | $630.96 | $870.96 |
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 $457.09 Median $724.44 Typical High $1,148.15 | Professional | None | $457.09 | $724.44 | $1,148.15 |
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 $229.09 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $229.09 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $91.20 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $346.74 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $69.18 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $45.71 | $64.57 | $64.57 |
Where South Carolina sits
The same service costs 4.0 times more in Wisconsin 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
$646
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.