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 $346.74 Median $4,677.35 Typical High $16,595.87 | Facility | None | $346.74 | $4,677.35 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $1,288.25 Typical High $1,737.80 | Professional | None | $288.40 | $1,288.25 | $1,737.80 |
BCBS South Carolina Setting Facility Modifier None Typical Low $4,365.16 Median $7,585.78 Typical High $13,489.63 | Facility | None | $4,365.16 | $7,585.78 | $13,489.63 |
BCBS South Carolina Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $1,778.28 | Professional | None | $218.78 | $338.84 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $645.65 Typical High $2,137.96 | Professional | None | $338.84 | $645.65 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $691.83 Typical High $2,344.23 | Facility | None | $309.03 | $691.83 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,862.09 | $2,570.40 |
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 $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 $263.03 Median $1,174.90 Typical High $2,754.23 | Professional | None | $263.03 | $1,174.90 | $2,754.23 |
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 $144.54 Median $616.60 Typical High $870.96 | Professional | 52 · Reduced service | $144.54 | $616.60 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $245.47 Typical High $346.74 | Professional | 53 · Discontinued | $58.88 | $245.47 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $933.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $218.78 | $933.25 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $186.21 Typical High $263.03 | Professional | 55 · Aftercare only | $43.65 | $186.21 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $123.03 Typical High $173.78 | Professional | 56 · Pre-op care only | $29.51 | $123.03 | $173.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $912.01 Median $933.25 Typical High $1,380.38 | Professional | 51 · Multiple procedures | $912.01 | $933.25 | $1,380.38 |
Where South Carolina sits
The same service costs 4.7 times more in Wisconsin than in Nebraska. 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· 17th of 51
$1,380
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.