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 $48.98 Median $4,265.80 Typical High $16,595.87 | Facility | None | $48.98 | $4,265.80 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $89.13 Typical High $138.04 | Professional | None | $43.65 | $89.13 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $102.33 Median $173.78 Typical High $309.03 | Facility | None | $102.33 | $173.78 | $309.03 |
BCBS South Carolina Setting Professional Modifier None Typical Low $36.31 Median $40.74 Typical High $120.23 | Professional | None | $36.31 | $40.74 | $120.23 |
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 $38.90 Median $85.11 Typical High $128.82 | Professional | None | $38.90 | $85.11 | $128.82 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $281.84 | Professional | None | $112.20 | $120.23 | $281.84 |
Medcost Setting Facility Modifier None Typical Low $30.20 Median $112.20 Typical High $724.44 | Facility | None | $30.20 | $112.20 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $56.23 Median $107.15 Typical High $134.90 | Professional | None | $56.23 | $107.15 | $134.90 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $245.47 | Professional | None | $123.03 | $158.49 | $245.47 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $36.31 Median $74.13 Typical High $128.82 | Professional | None | $36.31 | $74.13 | $128.82 |
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 $39.81 Typical High $69.18 | Professional | 52 · Reduced service | $22.91 | $39.81 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $16.60 Typical High $27.54 | Professional | 53 · Discontinued | $9.33 | $16.60 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $60.26 Typical High $104.71 | Professional | 54 · Surgery only | $34.67 | $60.26 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $12.02 Typical High $20.89 | Professional | 55 · Aftercare only | $7.08 | $12.02 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $8.13 Typical High $13.80 | Professional | 56 · Pre-op care only | $4.68 | $8.13 | $13.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $28.18 Median $52.48 Typical High $83.18 | Professional | 51 · Multiple procedures | $28.18 | $52.48 | $83.18 |
Where South Carolina sits
The same service costs 3.4 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· 35th of 51
$85.11
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.