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 $169.82 Median $5,623.41 Typical High $21,877.62 | Facility | None | $169.82 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $537.03 Typical High $758.58 | Professional | None | $138.04 | $537.03 | $758.58 |
BCBS South Carolina Setting Professional Modifier None Typical Low $104.71 Median $257.04 Typical High $588.84 | Professional | None | $104.71 | $257.04 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $316.23 Typical High $891.25 | Professional | None | $151.36 | $316.23 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $331.13 Typical High $1,023.29 | Facility | None | $144.54 | $331.13 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $630.96 Typical High $954.99 | Professional | None | $213.80 | $630.96 | $954.99 |
Molina Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,000.00 | Professional | None | $524.81 | $691.83 | $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 $125.89 Median $354.81 Typical High $954.99 | Professional | None | $125.89 | $354.81 | $954.99 |
6 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 $69.18 Median $208.93 Typical High $380.19 | Professional | 52 · Reduced service | $69.18 | $208.93 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $83.18 Typical High $151.36 | Professional | 53 · Discontinued | $27.54 | $83.18 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $309.03 Typical High $575.44 | Professional | 54 · Surgery only | $104.71 | $309.03 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $61.66 Typical High $114.82 | Professional | 55 · Aftercare only | $20.89 | $61.66 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $41.69 Typical High $75.86 | Professional | 56 · Pre-op care only | $13.80 | $41.69 | $75.86 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $323.59 Typical High $501.19 | Professional | 51 · Multiple procedures | $107.15 | $323.59 | $501.19 |
Where South Carolina sits
The same service costs 4.0 times more in Wisconsin than in Maryland. 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
$525
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.