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 $489.78 Median $9,120.11 Typical High $21,877.62 | Facility | None | $489.78 | $9,120.11 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $1,584.89 Typical High $2,691.53 | Professional | None | $346.74 | $1,584.89 | $2,691.53 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $288.40 Typical High $575.44 | Professional | None | $173.78 | $288.40 | $575.44 |
BCBS South Carolina Setting Facility Modifier None Typical Low $6,165.95 Median $9,772.37 Typical High $19,498.45 | Facility | None | $6,165.95 | $9,772.37 | $19,498.45 |
BCBS South Carolina Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $2,454.71 | Professional | None | $316.23 | $467.74 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $912.01 Typical High $3,090.30 | Professional | None | $436.52 | $912.01 | $3,090.30 |
Medcost Setting Facility Modifier None Typical Low $389.05 Median $977.24 Typical High $3,630.78 | Facility | None | $389.05 | $977.24 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,238.72 Typical High $3,162.28 | Professional | None | $2,187.76 | $2,238.72 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $2,238.72 Median $3,019.95 Typical High $4,265.80 | Professional | None | $2,238.72 | $3,019.95 | $4,265.80 |
United Setting Facility Modifier None Typical Low $12,302.69 Median $20,892.96 Typical High $27,542.29 | Facility | None | $12,302.69 | $20,892.96 | $27,542.29 |
United Setting Professional Modifier None Typical Low $354.81 Median $1,513.56 Typical High $3,388.44 | Professional | None | $354.81 | $1,513.56 | $3,388.44 |
8 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 $204.17 Median $724.44 Typical High $1,348.96 | Professional | 52 · Reduced service | $204.17 | $724.44 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $295.12 Typical High $537.03 | Professional | 53 · Discontinued | $81.28 | $295.12 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $1,096.48 Typical High $1,995.26 | Professional | 54 · Surgery only | $302.00 | $1,096.48 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $218.78 Typical High $398.11 | Professional | 55 · Aftercare only | $60.26 | $218.78 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $147.91 Typical High $269.15 | Professional | 56 · Pre-op care only | $40.74 | $147.91 | $269.15 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $436.52 Typical High $870.96 | Professional | 50 · Both sides | $436.52 | $436.52 | $870.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,388.44 Median $3,388.44 Typical High $8,709.64 | Professional | 50 · Both sides | $3,388.44 | $3,388.44 | $8,709.64 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,122.02 Median $1,122.02 Typical High $2,884.03 | Professional | 51 · Multiple procedures | $1,122.02 | $1,122.02 | $2,884.03 |
Where South Carolina sits
The same service costs 6.2 times more in Washington 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· 9th of 51
$2,138
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.