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 $331.13 Median $4,897.79 Typical High $21,877.62 | Facility | None | $331.13 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $1,096.48 Typical High $1,698.24 | Professional | None | $234.42 | $1,096.48 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
BCBS South Carolina Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $1,659.59 | Professional | None | $213.80 | $302.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $616.60 Typical High $1,995.26 | Professional | None | $288.40 | $616.60 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $251.19 Median $676.08 Typical High $2,290.87 | Facility | None | $251.19 | $676.08 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,412.54 | $1,548.82 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $2,884.03 | Professional | None | $1,513.56 | $2,041.74 | $2,884.03 |
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 $239.88 Median $1,047.13 Typical High $2,290.87 | Professional | None | $239.88 | $1,047.13 | $2,290.87 |
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 $138.04 Median $501.19 Typical High $851.14 | Professional | 52 · Reduced service | $138.04 | $501.19 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $199.53 Typical High $338.84 | Professional | 53 · Discontinued | $54.95 | $199.53 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $758.58 Typical High $1,258.93 | Professional | 54 · Surgery only | $204.17 | $758.58 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $151.36 Typical High $257.04 | Professional | 55 · Aftercare only | $41.69 | $151.36 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $100.00 Typical High $169.82 | Professional | 56 · Pre-op care only | $27.54 | $100.00 | $169.82 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $2,290.87 Typical High $5,623.41 | Professional | 50 · Both sides | $2,290.87 | $2,290.87 | $5,623.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $758.58 Median $758.58 Typical High $1,862.09 | Professional | 51 · Multiple procedures | $758.58 | $758.58 | $1,862.09 |
Where South Carolina sits
The same service costs 6.5 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
$1,445
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.