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 $158.49 Median $5,623.41 Typical High $21,877.62 | Facility | None | $158.49 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $158.49 | Professional | None | $131.83 | $158.49 | $158.49 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $794.33 Typical High $3,235.94 | Facility | None | $512.86 | $794.33 | $3,235.94 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $346.74 Typical High $446.68 | Professional | None | $117.49 | $346.74 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $977.24 Typical High $1,479.11 | Facility | None | $457.09 | $977.24 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $302.00 | Professional | None | $162.18 | $234.42 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $363.08 | Professional | None | $288.40 | $309.03 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $173.78 Median $436.52 Typical High $1,096.48 | Facility | None | $173.78 | $436.52 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $512.86 | Professional | None | $154.88 | $281.84 | $512.86 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $190.55 | Professional | None | $95.50 | $123.03 | $190.55 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $363.08 | Professional | None | $114.82 | $165.96 | $363.08 |
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 $66.07 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $66.07 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $26.30 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $97.72 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $19.95 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $13.18 | $15.85 | $15.85 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $141.25 Typical High $257.04 | Professional | 51 · Multiple procedures | $95.50 | $141.25 | $257.04 |
Where South Carolina sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 29th of 51
$204
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.