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 $186.21 Median $4,897.79 Typical High $21,877.62 | Facility | None | $186.21 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $363.08 Typical High $489.78 | Professional | None | $186.21 | $363.08 | $489.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $794.33 Typical High $3,388.44 | Facility | None | $512.86 | $794.33 | $3,388.44 |
BCBS South Carolina Setting Professional Modifier None Typical Low $138.04 Median $338.84 Typical High $436.52 | Professional | None | $138.04 | $338.84 | $436.52 |
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 $181.97 Median $363.08 Typical High $524.81 | Professional | None | $181.97 | $363.08 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $1,023.29 | Professional | None | $512.86 | $549.54 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $186.21 Median $489.78 Typical High $1,096.48 | Facility | None | $186.21 | $489.78 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $489.78 | Professional | None | $389.05 | $478.63 | $489.78 |
Molina Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $851.14 | Professional | None | $426.58 | $562.34 | $851.14 |
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 $151.36 Median $323.59 Typical High $562.34 | Professional | None | $151.36 | $323.59 | $562.34 |
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 $91.20 Median $162.18 Typical High $245.47 | Professional | 52 · Reduced service | $91.20 | $162.18 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $64.57 Typical High $97.72 | Professional | 53 · Discontinued | $37.15 | $64.57 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $239.88 Typical High $371.54 | Professional | 54 · Surgery only | $138.04 | $239.88 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $51.29 Typical High $74.13 | Professional | 55 · Aftercare only | $27.54 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $32.36 Typical High $48.98 | Professional | 56 · Pre-op care only | $18.62 | $32.36 | $48.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $245.47 Typical High $295.12 | Professional | 51 · Multiple procedures | $194.98 | $245.47 | $295.12 |
Where South Carolina sits
The same service costs 4.5 times more in Alaska than in Washington, DC. 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· 28th of 51
$380
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.