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 $74.13 Median $117.49 Typical High $21,877.62 | Facility | None | $74.13 | $117.49 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $117.49 | Professional | None | $63.10 | $83.18 | $117.49 |
BCBS South Carolina Setting Professional Modifier None Typical Low $44.67 Median $79.43 Typical High $117.49 | Professional | None | $44.67 | $79.43 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $891.25 Typical High $1,995.26 | Facility | None | $602.56 | $891.25 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $114.82 Typical High $190.55 | Professional | None | $66.07 | $114.82 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $61.66 Median $107.15 Typical High $165.96 | Facility | None | $61.66 | $107.15 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $288.40 | Professional | None | $97.72 | $147.91 | $288.40 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $125.89 | Professional | None | $66.07 | $93.33 | $125.89 |
United Setting Facility Modifier None Typical Low $83.18 Median $426.58 Typical High $2,238.72 | Facility | None | $83.18 | $426.58 | $2,238.72 |
United Setting Professional Modifier None Typical Low $56.23 Median $100.00 Typical High $234.42 | Professional | None | $56.23 | $100.00 | $234.42 |
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 $32.36 Median $41.69 Typical High $58.88 | Professional | 52 · Reduced service | $32.36 | $41.69 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.60 Typical High $23.44 | Professional | 53 · Discontinued | $12.88 | $16.60 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $61.66 Typical High $89.13 | Professional | 54 · Surgery only | $47.86 | $61.66 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.30 Typical High $17.78 | Professional | 55 · Aftercare only | $9.55 | $12.30 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.32 Typical High $11.75 | Professional | 56 · Pre-op care only | $6.46 | $8.32 | $11.75 |
Where South Carolina sits
The same service costs 3.7 times more in Wisconsin than in Florida. 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· 42nd of 51
$91.20
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.