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 $102.33 Median $4,897.79 Typical High $21,877.62 | Facility | None | $102.33 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $134.90 | Professional | None | $93.33 | $102.33 | $134.90 |
BCBS South Carolina Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $162.18 | Professional | None | $70.79 | $100.00 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $112.20 Typical High $186.21 | Professional | None | $91.20 | $112.20 | $186.21 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $112.20 Typical High $218.78 | Facility | None | $89.13 | $112.20 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $120.23 Typical High $169.82 | Professional | None | $107.15 | $120.23 | $169.82 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $190.55 | Professional | None | $100.00 | $128.82 | $190.55 |
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 $77.62 Median $109.65 Typical High $194.98 | Professional | None | $77.62 | $109.65 | $194.98 |
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 $51.29 Typical High $67.61 | Professional | 52 · Reduced service | $45.71 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.42 Typical High $26.92 | Professional | 53 · Discontinued | $18.20 | $20.42 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $77.62 Typical High $102.33 | Professional | 54 · Surgery only | $69.18 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.49 Typical High $20.42 | Professional | 55 · Aftercare only | $13.80 | $15.49 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.23 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.12 | $10.23 | $13.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $53.70 Median $64.57 Typical High $97.72 | Professional | 51 · Multiple procedures | $53.70 | $64.57 | $97.72 |
Where South Carolina sits
The same service costs 3.8 times more in Alaska than in Florida. 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· 34th of 51
$112
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.