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 $117.49 Median $4,897.79 Typical High $21,877.62 | Facility | None | $117.49 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $190.55 Typical High $263.03 | Professional | None | $102.33 | $190.55 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,412.54 Typical High $4,677.35 | Facility | None | $512.86 | $1,412.54 | $4,677.35 |
BCBS South Carolina Setting Professional Modifier None Typical Low $77.62 Median $199.53 Typical High $467.74 | Professional | None | $77.62 | $199.53 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,778.28 Typical High $2,884.03 | Facility | None | $457.09 | $1,778.28 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $389.05 | Professional | None | $144.54 | $213.80 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $131.83 Median $436.52 Typical High $630.96 | Facility | None | $131.83 | $436.52 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $524.81 | Professional | None | $234.42 | $354.81 | $524.81 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $380.19 | Professional | None | $194.98 | $275.42 | $380.19 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $7,762.47 | Facility | None | $302.00 | $1,122.02 | $7,762.47 |
United Setting Professional Modifier None Typical Low $97.72 Median $213.80 Typical High $489.78 | Professional | None | $97.72 | $213.80 | $489.78 |
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 $50.12 Median $66.07 Typical High $131.83 | Professional | 52 · Reduced service | $50.12 | $66.07 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.30 Typical High $52.48 | Professional | 53 · Discontinued | $20.42 | $26.30 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $100.00 Typical High $194.98 | Professional | 54 · Surgery only | $75.86 | $100.00 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.95 Typical High $38.90 | Professional | 55 · Aftercare only | $15.14 | $19.95 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.18 Typical High $26.30 | Professional | 56 · Pre-op care only | $10.23 | $13.18 | $26.30 |
Where South Carolina sits
The same service costs 4.1 times more in Alaska 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· 18th of 51
$316
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.