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 $154.88 Median $4,897.79 Typical High $21,877.62 | Facility | None | $154.88 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $257.04 | Professional | None | $128.82 | $194.98 | $257.04 |
BCBS South Carolina Setting Facility Modifier None Typical Low $501.19 Median $891.25 Typical High $6,760.83 | Facility | None | $501.19 | $891.25 | $6,760.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $100.00 Median $190.55 Typical High $223.87 | Professional | None | $100.00 | $190.55 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $812.83 Typical High $1,348.96 | Facility | None | $457.09 | $812.83 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $371.54 | Professional | None | $128.82 | $213.80 | $371.54 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $436.52 Typical High $794.33 | Facility | None | $154.88 | $436.52 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $288.40 | Professional | None | $204.17 | $229.09 | $288.40 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $380.19 | Professional | None | $190.55 | $275.42 | $380.19 |
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 $120.23 Median $190.55 Typical High $331.13 | Professional | None | $120.23 | $190.55 | $331.13 |
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 $72.44 Median $87.10 Typical High $128.82 | Professional | 52 · Reduced service | $72.44 | $87.10 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $35.48 Typical High $51.29 | Professional | 53 · Discontinued | $29.51 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $131.83 Typical High $194.98 | Professional | 54 · Surgery only | $109.65 | $131.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $26.30 Typical High $38.90 | Professional | 55 · Aftercare only | $21.88 | $26.30 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $17.38 Typical High $25.70 | Professional | 56 · Pre-op care only | $14.79 | $17.38 | $25.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $123.03 Typical High $177.83 | Professional | 51 · Multiple procedures | $102.33 | $123.03 | $177.83 |
Where South Carolina sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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· 24th of 51
$240
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.