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 $47.86 Median $4,897.79 Typical High $21,877.62 | Facility | None | $47.86 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $117.49 Typical High $190.55 | Professional | None | $45.71 | $117.49 | $190.55 |
BCBS South Carolina Setting Facility Modifier None Typical Low $134.90 Median $245.47 Typical High $426.58 | Facility | None | $134.90 | $245.47 | $426.58 |
BCBS South Carolina Setting Professional Modifier None Typical Low $36.31 Median $61.66 Typical High $158.49 | Professional | None | $36.31 | $61.66 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $794.33 | Facility | None | $52.48 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $97.72 Typical High $199.53 | Professional | None | $39.81 | $97.72 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $398.11 | Professional | None | $75.86 | $81.28 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $45.71 Median $102.33 Typical High $190.55 | Facility | None | $45.71 | $102.33 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $154.88 Typical High $181.97 | Professional | None | $72.44 | $154.88 | $181.97 |
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 $36.31 Median $100.00 Typical High $181.97 | Professional | None | $36.31 | $100.00 | $181.97 |
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 $22.91 Median $48.98 Typical High $95.50 | Professional | 52 · Reduced service | $22.91 | $48.98 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $19.50 Typical High $38.02 | Professional | 53 · Discontinued | $9.12 | $19.50 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $74.13 Typical High $141.25 | Professional | 54 · Surgery only | $33.88 | $74.13 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $14.79 Typical High $28.18 | Professional | 55 · Aftercare only | $6.76 | $14.79 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $9.77 Typical High $19.05 | Professional | 56 · Pre-op care only | $4.57 | $9.77 | $19.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $36.31 Median $77.62 Typical High $114.82 | Professional | 51 · Multiple procedures | $36.31 | $77.62 | $114.82 |
Where South Carolina sits
The same service costs 4.6 times more in Wisconsin 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· 31st of 51
$120
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.