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 $660.69 Median $9,120.11 Typical High $22,908.68 | Facility | None | $660.69 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $660.69 | Professional | None | $478.63 | $660.69 | $660.69 |
BCBS South Carolina Setting Professional Modifier None Typical Low $436.52 Median $812.83 Typical High $1,230.27 | Professional | None | $436.52 | $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 $630.96 Median $691.83 Typical High $1,122.02 | Professional | None | $630.96 | $691.83 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $660.69 Typical High $1,318.26 | Facility | None | $512.86 | $660.69 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $707.95 | Professional | None | $549.54 | $707.95 | $707.95 |
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 $478.63 Median $758.58 Typical High $1,202.26 | Professional | None | $478.63 | $758.58 | $1,202.26 |
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 $239.88 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $239.88 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $95.50 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $363.08 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $72.44 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $47.86 | $66.07 | $66.07 |
Where South Carolina sits
The same service costs 3.8 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· 32nd of 51
$708
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.