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 $190.55 Median $4,677.35 Typical High $16,595.87 | Facility | None | $190.55 | $4,677.35 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $602.56 Typical High $794.33 | Professional | None | $154.88 | $602.56 | $794.33 |
BCBS South Carolina Setting Facility Modifier None Typical Low $331.13 Median $5,011.87 Typical High $9,332.54 | Facility | None | $331.13 | $5,011.87 | $9,332.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $120.23 Median $302.00 Typical High $724.44 | Professional | None | $120.23 | $302.00 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $346.74 Typical High $954.99 | Professional | None | $173.78 | $346.74 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $371.54 Typical High $1,096.48 | Facility | None | $169.82 | $371.54 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $676.08 Typical High $1,148.15 | Professional | None | $257.04 | $676.08 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,122.02 | Professional | None | $588.84 | $812.83 | $1,122.02 |
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 $141.25 Median $398.11 Typical High $1,148.15 | Professional | None | $141.25 | $398.11 | $1,148.15 |
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 $79.43 Median $257.04 Typical High $398.11 | Professional | 52 · Reduced service | $79.43 | $257.04 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $102.33 Typical High $162.18 | Professional | 53 · Discontinued | $31.62 | $102.33 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $389.05 Typical High $602.56 | Professional | 54 · Surgery only | $117.49 | $389.05 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $77.62 Typical High $120.23 | Professional | 55 · Aftercare only | $23.44 | $77.62 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $51.29 Typical High $79.43 | Professional | 56 · Pre-op care only | $15.85 | $51.29 | $79.43 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $1,148.15 Typical High $1,737.80 | Professional | 50 · Both sides | $380.19 | $1,148.15 | $1,737.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $380.19 Typical High $575.44 | Professional | 51 · Multiple procedures | $128.82 | $380.19 | $575.44 |
Where South Carolina sits
The same service costs 3.8 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· 24th of 51
$575
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.