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 $83.18 Median $4,265.80 Typical High $16,595.87 | Facility | None | $83.18 | $4,265.80 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $380.19 Typical High $489.78 | Professional | None | $83.18 | $380.19 | $489.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,090.30 Median $4,570.88 Typical High $10,715.19 | Facility | None | $3,090.30 | $4,570.88 | $10,715.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $60.26 Median $186.21 Typical High $371.54 | Professional | None | $60.26 | $186.21 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $676.08 | Professional | None | $107.15 | $204.17 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $190.55 Typical High $660.69 | Facility | None | $83.18 | $190.55 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $660.69 | Professional | None | $478.63 | $489.78 | $660.69 |
Molina Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $741.31 | Professional | None | $389.05 | $524.81 | $741.31 |
United Setting Facility Modifier None Typical Low $7,585.78 Median $15,135.61 Typical High $23,442.29 | Facility | None | $7,585.78 | $15,135.61 | $23,442.29 |
United Setting Professional Modifier None Typical Low $74.13 Median $309.03 Typical High $691.83 | Professional | None | $74.13 | $309.03 | $691.83 |
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 $41.69 Median $158.49 Typical High $245.47 | Professional | 52 · Reduced service | $41.69 | $158.49 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $63.10 Typical High $100.00 | Professional | 53 · Discontinued | $16.60 | $63.10 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $234.42 Typical High $371.54 | Professional | 54 · Surgery only | $61.66 | $234.42 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $46.77 Typical High $74.13 | Professional | 55 · Aftercare only | $12.30 | $46.77 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $31.62 Typical High $48.98 | Professional | 56 · Pre-op care only | $8.32 | $31.62 | $48.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $245.47 Median $245.47 Typical High $602.56 | Professional | 51 · Multiple procedures | $245.47 | $245.47 | $602.56 |
Where South Carolina sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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· 27th of 51
$372
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.