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 $128.82 Median $4,897.79 Typical High $21,877.62 | Facility | None | $128.82 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $257.04 | Professional | None | $125.89 | $199.53 | $257.04 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $870.96 Typical High $3,801.89 | Facility | None | $512.86 | $870.96 | $3,801.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $97.72 Median $158.49 Typical High $223.87 | Professional | None | $97.72 | $158.49 | $223.87 |
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 $117.49 Median $199.53 Typical High $309.03 | Professional | None | $117.49 | $199.53 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $512.86 | Professional | None | $213.80 | $229.09 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $436.52 Typical High $630.96 | Facility | None | $128.82 | $436.52 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $269.15 | Professional | None | $204.17 | $251.19 | $269.15 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $426.58 | Professional | None | $213.80 | $281.84 | $426.58 |
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 $100.00 Median $169.82 Typical High $281.84 | Professional | None | $100.00 | $169.82 | $281.84 |
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 $63.10 Median $95.50 Typical High $128.82 | Professional | 52 · Reduced service | $63.10 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $38.90 Typical High $52.48 | Professional | 53 · Discontinued | $25.12 | $38.90 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $144.54 Typical High $194.98 | Professional | 54 · Surgery only | $95.50 | $144.54 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.84 Typical High $38.90 | Professional | 55 · Aftercare only | $19.05 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $19.50 Typical High $25.70 | Professional | 56 · Pre-op care only | $12.59 | $19.50 | $25.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $128.82 Typical High $158.49 | Professional | 51 · Multiple procedures | $102.33 | $128.82 | $158.49 |
Where South Carolina sits
The same service costs 3.8 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· 30th of 51
$209
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.