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 $208.93 Median $5,623.41 Typical High $21,877.62 | Facility | None | $208.93 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $1,445.44 Typical High $1,905.46 | Professional | None | $158.49 | $1,445.44 | $1,905.46 |
BCBS South Carolina Setting Facility Modifier None Typical Low $812.83 Median $1,778.28 Typical High $3,981.07 | Facility | None | $812.83 | $1,778.28 | $3,981.07 |
BCBS South Carolina Setting Professional Modifier None Typical Low $123.03 Median $1,230.27 Typical High $1,513.56 | Professional | None | $123.03 | $1,230.27 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $3,090.30 | Facility | None | $602.56 | $1,318.26 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $467.74 Typical High $2,691.53 | Professional | None | $186.21 | $467.74 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $870.96 Typical High $2,290.87 | Facility | None | $208.93 | $870.96 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $2,344.23 | Professional | None | $1,584.89 | $2,187.76 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $1,288.25 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,288.25 | $1,949.84 | $2,630.27 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $151.36 Median $1,258.93 Typical High $3,090.30 | Professional | None | $151.36 | $1,258.93 | $3,090.30 |
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 $93.33 Median $117.49 Typical High $954.99 | Professional | 52 · Reduced service | $93.33 | $117.49 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $46.77 Typical High $380.19 | Professional | 53 · Discontinued | $37.15 | $46.77 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $173.78 Typical High $1,445.44 | Professional | 54 · Surgery only | $141.25 | $173.78 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $34.67 Typical High $288.40 | Professional | 55 · Aftercare only | $28.18 | $34.67 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $23.44 Typical High $190.55 | Professional | 56 · Pre-op care only | $18.62 | $23.44 | $190.55 |
Where South Carolina sits
The same service costs 8.5 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· 22nd of 51
$1,445
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.