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 $81.28 Median $144.54 Typical High $21,877.62 | Facility | None | $81.28 | $144.54 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $162.18 | Professional | None | $79.43 | $112.20 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
BCBS South Carolina Setting Facility Modifier None Typical Low $501.19 Median $851.14 Typical High $1,584.89 | Facility | None | $501.19 | $851.14 | $1,584.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $54.95 Median $102.33 Typical High $138.04 | Professional | None | $54.95 | $102.33 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $91.20 Typical High $151.36 | Facility | None | $75.86 | $91.20 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $165.96 | Professional | None | $75.86 | $125.89 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Medcost Setting Facility Modifier None Typical Low $81.28 Median $144.54 Typical High $724.44 | Facility | None | $81.28 | $144.54 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $158.49 | Professional | None | $123.03 | $141.25 | $158.49 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $169.82 | Professional | None | $95.50 | $117.49 | $169.82 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $63.10 Median $109.65 Typical High $186.21 | Professional | None | $63.10 | $109.65 | $186.21 |
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 $40.74 Median $40.74 Typical High $72.44 | Professional | 52 · Reduced service | $40.74 | $40.74 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $28.84 | Professional | 53 · Discontinued | $16.60 | $16.60 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $107.15 | Professional | 54 · Surgery only | $61.66 | $61.66 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $21.88 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $14.45 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $14.45 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $61.66 Median $77.62 Typical High $87.10 | Professional | 51 · Multiple procedures | $61.66 | $77.62 | $87.10 |
Where South Carolina sits
The same service costs 3.3 times more in Alaska than in Maryland. 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
$117
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.