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 $95.50 Median $4,897.79 Typical High $21,877.62 | Facility | None | $95.50 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $162.18 Typical High $263.03 | Professional | None | $87.10 | $162.18 | $263.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $1,202.26 Typical High $3,801.89 | Facility | None | $676.08 | $1,202.26 | $3,801.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $72.44 Median $141.25 Typical High $223.87 | Professional | None | $72.44 | $141.25 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $575.44 Typical High $912.01 | Facility | None | $457.09 | $575.44 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $181.97 Typical High $257.04 | Professional | None | $85.11 | $181.97 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $537.03 | Professional | None | $281.84 | $302.00 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $97.72 Median $436.52 Typical High $851.14 | Facility | None | $97.72 | $436.52 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $263.03 | Professional | None | $177.83 | $251.19 | $263.03 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $426.58 | Professional | None | $213.80 | $275.42 | $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 $75.86 Median $162.18 Typical High $295.12 | Professional | None | $75.86 | $162.18 | $295.12 |
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 $45.71 Median $81.28 Typical High $131.83 | Professional | 52 · Reduced service | $45.71 | $81.28 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $32.36 Typical High $52.48 | Professional | 53 · Discontinued | $18.62 | $32.36 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $120.23 Typical High $194.98 | Professional | 54 · Surgery only | $69.18 | $120.23 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $23.99 Typical High $38.90 | Professional | 55 · Aftercare only | $13.80 | $23.99 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $16.22 Typical High $26.30 | Professional | 56 · Pre-op care only | $9.12 | $16.22 | $26.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $89.13 Median $131.83 Typical High $158.49 | Professional | 51 · Multiple procedures | $89.13 | $131.83 | $158.49 |
Where South Carolina sits
The same service costs 4.1 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· 31st of 51
$182
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.