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 $630.96 Median $9,120.11 Typical High $22,908.68 | Facility | None | $630.96 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $630.96 | Professional | None | $457.09 | $630.96 | $630.96 |
BCBS South Carolina Setting Professional Modifier None Typical Low $416.87 Median $812.83 Typical High $1,230.27 | Professional | None | $416.87 | $812.83 | $1,230.27 |
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 $616.60 Median $660.69 Typical High $1,071.52 | Professional | None | $616.60 | $660.69 | $1,071.52 |
Medcost Setting Facility Modifier None Typical Low $478.63 Median $630.96 Typical High $1,258.93 | Facility | None | $478.63 | $630.96 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $691.83 | Professional | None | $524.81 | $691.83 | $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 $741.31 Typical High $1,148.15 | Professional | None | $457.09 | $741.31 | $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 $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $229.09 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $91.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $338.84 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $67.61 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $45.71 | $63.10 | $63.10 |
Where South Carolina sits
The same service costs 3.9 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· 30th of 51
$692
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.