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 $323.59 Median $10,000.00 Typical High $21,877.62 | Facility | None | $323.59 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $323.59 | Professional | None | $257.04 | $323.59 | $323.59 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,388.44 Typical High $10,471.29 | Facility | None | $851.14 | $3,388.44 | $10,471.29 |
BCBS South Carolina Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $501.19 | Professional | None | $223.87 | $331.13 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,630.27 | Facility | None | $602.56 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $309.03 Typical High $575.44 | Professional | None | $302.00 | $309.03 | $575.44 |
Medcost Setting Facility Modifier None Typical Low $295.12 Median $724.44 Typical High $1,698.24 | Facility | None | $295.12 | $724.44 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $398.11 | Professional | None | $302.00 | $354.81 | $398.11 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $457.09 | Professional | None | $229.09 | $331.13 | $457.09 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $549.54 | Professional | None | $257.04 | $331.13 | $549.54 |
4 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 54 · Surgery only Typical Low $194.98 Median $239.88 Typical High $239.88 | Professional | 54 · Surgery only | $194.98 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $38.90 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $25.70 | $32.36 | $32.36 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $173.78 Median $181.97 Typical High $251.19 | Professional | 51 · Multiple procedures | $173.78 | $181.97 | $251.19 |
Where South Carolina sits
The same service costs 7.2 times more in Oklahoma than in New York. 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
$380
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.