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 $338.84 Median $5,623.41 Typical High $21,877.62 | Facility | None | $338.84 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $831.76 Typical High $1,380.38 | Professional | None | $281.84 | $831.76 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
BCBS South Carolina Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $213.80 Median $467.74 Typical High $1,288.25 | Professional | None | $213.80 | $467.74 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $630.96 Typical High $1,584.89 | Professional | None | $309.03 | $630.96 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Medcost Setting Facility Modifier None Typical Low $302.00 Median $676.08 Typical High $1,513.56 | Facility | None | $302.00 | $676.08 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $1,047.13 Typical High $2,089.30 | Professional | None | $446.68 | $1,047.13 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,513.56 | Professional | None | $794.33 | $1,071.52 | $1,513.56 |
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 $257.04 Median $707.95 Typical High $2,089.30 | Professional | None | $257.04 | $707.95 | $2,089.30 |
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 $144.54 Median $416.87 Typical High $562.34 | Professional | 52 · Reduced service | $144.54 | $416.87 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $165.96 Typical High $229.09 | Professional | 53 · Discontinued | $57.54 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $630.96 Typical High $851.14 | Professional | 54 · Surgery only | $218.78 | $630.96 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $125.89 Typical High $169.82 | Professional | 55 · Aftercare only | $43.65 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $83.18 Typical High $112.20 | Professional | 56 · Pre-op care only | $28.84 | $83.18 | $112.20 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $1,621.81 Typical High $3,090.30 | Professional | 50 · Both sides | $660.69 | $1,621.81 | $3,090.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $537.03 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $223.87 | $537.03 | $1,047.13 |
Where South Carolina sits
The same service costs 4.3 times more in Wisconsin 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· 22nd of 51
$813
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.