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 $316.23 Median $5,623.41 Typical High $21,877.62 | Facility | None | $316.23 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $436.52 | Professional | None | $275.42 | $316.23 | $436.52 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $1,122.02 Typical High $2,754.23 | Facility | None | $676.08 | $1,122.02 | $2,754.23 |
BCBS South Carolina Setting Professional Modifier None Typical Low $234.42 Median $416.87 Typical High $524.81 | Professional | None | $234.42 | $416.87 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,454.71 Typical High $3,548.13 | Facility | None | $602.56 | $2,454.71 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $794.33 | Professional | None | $323.59 | $467.74 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $316.23 Median $588.84 Typical High $1,096.48 | Facility | None | $316.23 | $588.84 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $794.33 | Professional | None | $457.09 | $575.44 | $794.33 |
Molina Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $691.83 | Professional | None | $354.81 | $467.74 | $691.83 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $7,762.47 | Facility | None | $302.00 | $1,122.02 | $7,762.47 |
United Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $758.58 | Professional | None | $281.84 | $398.11 | $758.58 |
7 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 $151.36 Median $165.96 Typical High $218.78 | Professional | 52 · Reduced service | $151.36 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $66.07 Typical High $87.10 | Professional | 53 · Discontinued | $60.26 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $245.47 Typical High $323.59 | Professional | 54 · Surgery only | $223.87 | $245.47 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $50.12 Typical High $66.07 | Professional | 55 · Aftercare only | $45.71 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.11 Typical High $43.65 | Professional | 56 · Pre-op care only | $30.20 | $33.11 | $43.65 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 59 · Distinct service | $257.04 | $257.04 | $257.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $288.40 Typical High $398.11 | Professional | 51 · Multiple procedures | $263.03 | $288.40 | $398.11 |
Where South Carolina sits
The same service costs 3.9 times more in Alaska 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· 31st of 51
$457
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.