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 $162.18 Median $5,623.41 Typical High $21,877.62 | Facility | None | $162.18 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $162.18 | Professional | None | $112.20 | $162.18 | $162.18 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $12,302.69 | Facility | None | $512.86 | $1,949.84 | $12,302.69 |
BCBS South Carolina Setting Professional Modifier None Typical Low $97.72 Median $162.18 Typical High $295.12 | Professional | None | $97.72 | $162.18 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,479.11 Typical High $3,162.28 | Facility | None | $457.09 | $1,479.11 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $302.00 | Professional | None | $131.83 | $158.49 | $302.00 |
Medcost Setting Facility Modifier None Typical Low $147.91 Median $478.63 Typical High $1,584.89 | Facility | None | $147.91 | $478.63 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $295.12 | Professional | None | $141.25 | $199.53 | $295.12 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $190.55 | Professional | None | $100.00 | $138.04 | $190.55 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $288.40 | Professional | None | $114.82 | $169.82 | $288.40 |
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 $56.23 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $56.23 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $22.91 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $85.11 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $16.98 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $11.22 | $16.22 | $16.22 |
Where South Carolina sits
The same service costs 12.9 times more in Arkansas 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· 36th of 51
$200
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.