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 $269.15 Median $5,623.41 Typical High $21,877.62 | Facility | None | $269.15 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $269.15 | Professional | None | $223.87 | $269.15 | $269.15 |
BCBS South Carolina Setting Facility Modifier None Typical Low $489.78 Median $758.58 Typical High $1,258.93 | Facility | None | $489.78 | $758.58 | $1,258.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $263.03 | Professional | None | $194.98 | $251.19 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $812.83 Typical High $1,621.81 | Facility | None | $602.56 | $812.83 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $281.84 Typical High $549.54 | Professional | None | $263.03 | $281.84 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $269.15 Median $616.60 Typical High $724.44 | Facility | None | $269.15 | $616.60 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $331.13 | Professional | None | $263.03 | $331.13 | $331.13 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $380.19 | Professional | None | $194.98 | $245.47 | $380.19 |
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 $194.98 Median $239.88 Typical High $457.09 | Professional | None | $194.98 | $239.88 | $457.09 |
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 $112.20 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $112.20 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $44.67 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $165.96 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $33.88 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $22.39 | $26.92 | $26.92 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | 51 · Multiple procedures | $162.18 | $162.18 | $165.96 |
Where South Carolina sits
The same service costs 4.7 times more in Wyoming 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· 38th of 51
$263
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.