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 $54.95 Median $5,623.41 Typical High $21,877.62 | Facility | None | $54.95 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $54.95 Typical High $54.95 | Professional | None | $39.81 | $54.95 | $54.95 |
BCBS South Carolina Setting Facility Modifier None Typical Low $34.67 Median $56.23 Typical High $109.65 | Facility | None | $34.67 | $56.23 | $109.65 |
BCBS South Carolina Setting Professional Modifier None Typical Low $32.36 Median $44.67 Typical High $81.28 | Professional | None | $32.36 | $44.67 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $794.33 | Facility | None | $52.48 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $53.70 Typical High $104.71 | Professional | None | $41.69 | $53.70 | $104.71 |
Medcost Setting Facility Modifier None Typical Low $14.45 Median $22.39 Typical High $60.26 | Facility | None | $14.45 | $22.39 | $60.26 |
Medcost Setting Professional Modifier None Typical Low $45.71 Median $63.10 Typical High $93.33 | Professional | None | $45.71 | $63.10 | $93.33 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $51.29 Typical High $66.07 | Professional | None | $35.48 | $51.29 | $66.07 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $38.90 Median $56.23 Typical High $100.00 | Professional | None | $38.90 | $56.23 | $100.00 |
5 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 $19.50 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $19.50 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $7.94 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $40.74 Typical High $40.74 | Professional | 54 · Surgery only | $29.51 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $5.89 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.98 | $5.50 | $5.50 |
Where South Carolina sits
The same service costs 9.3 times more in Tennessee than in New York. 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· 41st of 51
$56.23
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.