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 $251.19 Median $9,120.11 Typical High $22,908.68 | Facility | None | $251.19 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $251.19 | Professional | None | $177.83 | $251.19 | $251.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $162.18 Median $426.58 Typical High $645.65 | Professional | None | $162.18 | $426.58 | $645.65 |
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 $223.87 Median $257.04 Typical High $426.58 | Professional | None | $223.87 | $257.04 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $251.19 Typical High $489.78 | Facility | None | $190.55 | $251.19 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $275.42 | Professional | None | $204.17 | $269.15 | $275.42 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $338.84 | Professional | None | $165.96 | $239.88 | $338.84 |
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 $177.83 Median $288.40 Typical High $457.09 | Professional | None | $177.83 | $288.40 | $457.09 |
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 $89.13 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $89.13 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $35.48 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $134.90 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $26.92 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $17.78 | $25.12 | $25.12 |
Where South Carolina sits
The same service costs 4.3 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· 37th of 51
$282
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.