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 $269.15 Median $1,412.54 Typical High $16,595.87 | Facility | None | $269.15 | $1,412.54 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $1,000.00 Typical High $1,348.96 | Professional | None | $218.78 | $1,000.00 | $1,348.96 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,715.35 Median $6,309.57 Typical High $12,589.25 | Facility | None | $3,715.35 | $6,309.57 | $12,589.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $1,621.81 | Professional | None | $173.78 | $275.42 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $501.19 Typical High $1,659.59 | Professional | None | $257.04 | $501.19 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $537.03 Typical High $1,819.70 | Facility | None | $239.88 | $537.03 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,479.11 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $1,819.70 | Professional | None | $954.99 | $1,288.25 | $1,819.70 |
United Setting Facility Modifier None Typical Low $7,585.78 Median $14,125.38 Typical High $22,908.68 | Facility | None | $7,585.78 | $14,125.38 | $22,908.68 |
United Setting Professional Modifier None Typical Low $204.17 Median $912.01 Typical High $2,137.96 | Professional | None | $204.17 | $912.01 | $2,137.96 |
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 $112.20 Median $489.78 Typical High $676.08 | Professional | 52 · Reduced service | $112.20 | $489.78 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $194.98 Typical High $269.15 | Professional | 53 · Discontinued | $45.71 | $194.98 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $741.31 Typical High $1,000.00 | Professional | 54 · Surgery only | $169.82 | $741.31 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $147.91 Typical High $199.53 | Professional | 55 · Aftercare only | $33.88 | $147.91 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $97.72 Typical High $134.90 | Professional | 56 · Pre-op care only | $22.91 | $97.72 | $134.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $741.31 Typical High $1,412.54 | Professional | 51 · Multiple procedures | $691.83 | $741.31 | $1,412.54 |
Where South Carolina sits
The same service costs 5.9 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· 18th of 51
$1,072
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.