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 $169.82 Median $5,623.41 Typical High $21,877.62 | Facility | None | $169.82 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $169.82 | Professional | None | $123.03 | $169.82 | $169.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $870.96 Typical High $1,548.82 | Facility | None | $512.86 | $870.96 | $1,548.82 |
BCBS South Carolina Setting Professional Modifier None Typical Low $109.65 Median $213.80 Typical High $245.47 | Professional | None | $109.65 | $213.80 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $436.52 Typical High $741.31 | Facility | None | $275.42 | $436.52 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $213.80 | Professional | None | $141.25 | $141.25 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $288.40 | Professional | None | $186.21 | $199.53 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $131.83 Median $251.19 Typical High $323.59 | Facility | None | $131.83 | $251.19 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $251.19 | Professional | None | $141.25 | $165.96 | $251.19 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $190.55 | Professional | None | $91.20 | $123.03 | $190.55 |
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 $107.15 Median $128.82 Typical High $229.09 | Professional | None | $107.15 | $128.82 | $229.09 |
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 $61.66 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $61.66 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $24.55 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $128.82 Typical High $128.82 | Professional | 54 · Surgery only | $91.20 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $18.20 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $12.30 | $16.98 | $16.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $79.43 Median $89.13 Typical High $134.90 | Professional | 51 · Multiple procedures | $79.43 | $89.13 | $134.90 |
Where South Carolina sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 26th of 51
$162
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.