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 $100.00 Median $4,897.79 Typical High $21,877.62 | Facility | None | $100.00 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $588.84 Typical High $1,122.02 | Professional | None | $97.72 | $588.84 | $1,122.02 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,412.54 Median $2,454.71 Typical High $4,365.16 | Facility | None | $1,412.54 | $2,454.71 | $4,365.16 |
BCBS South Carolina Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $954.99 | Professional | None | $61.66 | $87.10 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $741.31 Typical High $1,174.90 | Facility | None | $457.09 | $741.31 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $257.04 Typical High $1,202.26 | Professional | None | $83.18 | $257.04 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,047.13 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,047.13 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $100.00 Median $691.83 Typical High $1,122.02 | Facility | None | $100.00 | $691.83 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $1,000.00 Typical High $1,071.52 | Professional | None | $97.72 | $1,000.00 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,819.70 | Professional | None | $912.01 | $1,174.90 | $1,819.70 |
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 $61.66 Median $295.12 Typical High $1,202.26 | Professional | None | $61.66 | $295.12 | $1,202.26 |
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 $48.98 Median $316.23 Typical High $549.54 | Professional | 52 · Reduced service | $48.98 | $316.23 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $125.89 Typical High $223.87 | Professional | 53 · Discontinued | $19.50 | $125.89 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $478.63 Typical High $831.76 | Professional | 54 · Surgery only | $72.44 | $478.63 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $95.50 Typical High $165.96 | Professional | 55 · Aftercare only | $14.45 | $95.50 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $63.10 Typical High $112.20 | Professional | 56 · Pre-op care only | $9.77 | $63.10 | $112.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $501.19 Typical High $676.08 | Professional | 51 · Multiple procedures | $48.98 | $501.19 | $676.08 |
Where South Carolina sits
The same service costs 14.1 times more in Washington than in Kentucky. 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
$724
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.