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 $57.54 Median $4,897.79 Typical High $21,877.62 | Facility | None | $57.54 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $112.20 Typical High $151.36 | Professional | None | $52.48 | $112.20 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
BCBS South Carolina Setting Facility Modifier None Typical Low $870.96 Median $1,513.56 Typical High $2,630.27 | Facility | None | $870.96 | $1,513.56 | $2,630.27 |
BCBS South Carolina Setting Professional Modifier None Typical Low $43.65 Median $66.07 Typical High $138.04 | Professional | None | $43.65 | $66.07 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $295.12 Typical High $707.95 | Facility | None | $134.90 | $295.12 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $93.33 Typical High $158.49 | Professional | None | $50.12 | $93.33 | $158.49 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $107.15 Typical High $309.03 | Professional | None | $100.00 | $107.15 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $57.54 Median $151.36 Typical High $165.96 | Facility | None | $57.54 | $151.36 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $144.54 | Professional | None | $85.11 | $131.83 | $144.54 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $302.00 | Professional | None | $154.88 | $199.53 | $302.00 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,165.95 | Facility | None | $302.00 | $1,122.02 | $6,165.95 |
United Setting Professional Modifier None Typical Low $39.81 Median $89.13 Typical High $151.36 | Professional | None | $39.81 | $89.13 | $151.36 |
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 $27.54 Median $48.98 Typical High $74.13 | Professional | 52 · Reduced service | $27.54 | $48.98 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $19.95 Typical High $30.20 | Professional | 53 · Discontinued | $11.22 | $19.95 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $72.44 Typical High $112.20 | Professional | 54 · Surgery only | $41.69 | $72.44 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $15.14 Typical High $22.39 | Professional | 55 · Aftercare only | $8.32 | $15.14 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $10.00 Typical High $15.14 | Professional | 56 · Pre-op care only | $5.62 | $10.00 | $15.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $42.66 Median $66.07 Typical High $91.20 | Professional | 51 · Multiple procedures | $42.66 | $66.07 | $91.20 |
Where South Carolina sits
The same service costs 3.5 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· 34th of 51
$105
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.