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 $69.18 Median $4,897.79 Typical High $21,877.62 | Facility | None | $69.18 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $72.44 Typical High $89.13 | Professional | None | $63.10 | $72.44 | $89.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $3,548.13 | Facility | None | $1,174.90 | $1,995.26 | $3,548.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $51.29 Median $61.66 Typical High $81.28 | Professional | None | $51.29 | $61.66 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $120.23 Typical High $707.95 | Facility | None | $54.95 | $120.23 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $83.18 Typical High $117.49 | Professional | None | $61.66 | $83.18 | $117.49 |
Medcost Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $186.21 | Professional | None | $104.71 | $112.20 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $64.57 Median $93.33 Typical High $114.82 | Facility | None | $64.57 | $93.33 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $100.00 | Professional | None | $69.18 | $89.13 | $100.00 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $125.89 | Professional | None | $63.10 | $81.28 | $125.89 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $52.48 Median $75.86 Typical High $125.89 | Professional | None | $52.48 | $75.86 | $125.89 |
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 $33.11 Median $36.31 Typical High $43.65 | Professional | 52 · Reduced service | $33.11 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $14.45 Typical High $17.78 | Professional | 53 · Discontinued | $13.18 | $14.45 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $54.95 Typical High $66.07 | Professional | 54 · Surgery only | $50.12 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.96 Typical High $13.18 | Professional | 55 · Aftercare only | $10.00 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.24 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.61 | $7.24 | $8.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $34.67 Median $50.12 Typical High $53.70 | Professional | 51 · Multiple procedures | $34.67 | $50.12 | $53.70 |
Where South Carolina sits
The same service costs 4.3 times more in Alaska than in New Jersey. 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
$75.86
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.