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 $53.70 Median $257.04 Typical High $9,120.11 | Facility | None | $53.70 | $257.04 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $109.65 Typical High $257.04 | Professional | None | $46.77 | $109.65 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $67.61 Typical High $107.15 | Professional | None | $39.81 | $67.61 | $107.15 |
BCBS South Carolina Setting Facility Modifier None Typical Low $33.88 Median $39.81 Typical High $194.98 | Facility | None | $33.88 | $39.81 | $194.98 |
BCBS South Carolina Setting Professional Modifier None Typical Low $36.31 Median $66.07 Typical High $245.47 | Professional | None | $36.31 | $66.07 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $154.88 Typical High $338.84 | Professional | None | $51.29 | $154.88 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $48.98 Median $117.49 Typical High $346.74 | Facility | None | $48.98 | $117.49 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $489.78 | Professional | None | $194.98 | $251.19 | $489.78 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $371.54 | Professional | None | $199.53 | $263.03 | $371.54 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $2,951.21 | Facility | None | $446.68 | $1,621.81 | $2,951.21 |
United Setting Professional Modifier None Typical Low $43.65 Median $162.18 Typical High $354.81 | Professional | None | $43.65 | $162.18 | $354.81 |
5 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 $22.39 Median $75.86 Typical High $128.82 | Professional | 52 · Reduced service | $22.39 | $75.86 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $30.90 Typical High $51.29 | Professional | 53 · Discontinued | $8.91 | $30.90 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $22.91 Typical High $38.02 | Professional | 55 · Aftercare only | $6.76 | $22.91 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $15.14 Typical High $25.70 | Professional | 56 · Pre-op care only | $4.47 | $15.14 | $25.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $97.72 Median $147.91 Typical High $309.03 | Professional | 51 · Multiple procedures | $97.72 | $147.91 | $309.03 |
Where South Carolina sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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· 16th of 51
$195
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.