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 $208.93 Median $4,897.79 Typical High $21,877.62 | Facility | None | $208.93 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $549.54 Typical High $758.58 | Professional | None | $177.83 | $549.54 | $758.58 |
BCBS South Carolina Setting Professional Modifier None Typical Low $128.82 Median $295.12 Typical High $562.34 | Professional | None | $128.82 | $295.12 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $380.19 Typical High $851.14 | Professional | None | $181.97 | $380.19 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $177.83 Median $407.38 Typical High $1,023.29 | Facility | None | $177.83 | $407.38 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $630.96 Typical High $891.25 | Professional | None | $257.04 | $630.96 | $891.25 |
Molina Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $1,000.00 | Professional | None | $524.81 | $724.44 | $1,000.00 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $2,951.21 | Facility | None | $446.68 | $1,621.81 | $2,951.21 |
United Setting Professional Modifier None Typical Low $154.88 Median $416.87 Typical High $933.25 | Professional | None | $154.88 | $416.87 | $933.25 |
7 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 $87.10 Median $213.80 Typical High $380.19 | Professional | 52 · Reduced service | $87.10 | $213.80 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $85.11 Typical High $151.36 | Professional | 53 · Discontinued | $35.48 | $85.11 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $316.23 Typical High $575.44 | Professional | 54 · Surgery only | $131.83 | $316.23 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $63.10 Typical High $114.82 | Professional | 55 · Aftercare only | $26.30 | $63.10 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $42.66 Typical High $75.86 | Professional | 56 · Pre-op care only | $17.78 | $42.66 | $75.86 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $977.24 Typical High $1,513.56 | Professional | 50 · Both sides | $389.05 | $977.24 | $1,513.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $323.59 Typical High $501.19 | Professional | 51 · Multiple procedures | $128.82 | $323.59 | $501.19 |
Where South Carolina sits
The same service costs 3.5 times more in Wisconsin than in Nebraska. 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· 22nd of 51
$513
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.