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 $323.59 Median $4,677.35 Typical High $16,595.87 | Facility | None | $323.59 | $4,677.35 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $1,122.02 Typical High $1,698.24 | Professional | None | $263.03 | $1,122.02 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
BCBS South Carolina Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $199.53 Median $457.09 Typical High $1,348.96 | Professional | None | $199.53 | $457.09 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $588.84 Typical High $1,949.84 | Professional | None | $281.84 | $588.84 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $269.15 Median $630.96 Typical High $2,290.87 | Facility | None | $269.15 | $630.96 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $1,380.38 Typical High $2,187.76 | Professional | None | $398.11 | $1,380.38 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,659.59 | $2,290.87 |
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 $676.08 Typical High $2,238.72 | Professional | None | $239.88 | $676.08 | $2,238.72 |
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 $134.90 Median $489.78 Typical High $851.14 | Professional | 52 · Reduced service | $134.90 | $489.78 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $194.98 Typical High $338.84 | Professional | 53 · Discontinued | $53.70 | $194.98 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $724.44 Typical High $1,258.93 | Professional | 54 · Surgery only | $204.17 | $724.44 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $147.91 Typical High $251.19 | Professional | 55 · Aftercare only | $40.74 | $147.91 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $97.72 Typical High $169.82 | Professional | 56 · Pre-op care only | $26.92 | $97.72 | $169.82 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $2,290.87 Typical High $3,890.45 | Professional | 50 · Both sides | $602.56 | $2,290.87 | $3,890.45 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $199.53 Median $758.58 Typical High $1,288.25 | Professional | 51 · Multiple procedures | $199.53 | $758.58 | $1,288.25 |
Where South Carolina sits
The same service costs 5.8 times more in Washington than in Hawaii. 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
$1,175
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.