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 $100.00 Median $5,623.41 Typical High $21,877.62 | Facility | None | $100.00 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $169.82 | Professional | None | $97.72 | $125.89 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $112.20 Typical High $204.17 | Professional | None | $87.10 | $112.20 | $204.17 |
BCBS South Carolina Setting Facility Modifier None Typical Low $281.84 Median $575.44 Typical High $1,230.27 | Facility | None | $281.84 | $575.44 | $1,230.27 |
BCBS South Carolina Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $151.36 | Professional | None | $79.43 | $117.49 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $169.82 Typical High $707.95 | Facility | None | $77.62 | $169.82 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $223.87 | Professional | None | $97.72 | $123.03 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $89.13 Typical High $151.36 | Facility | None | $66.07 | $89.13 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $169.82 | Professional | None | $117.49 | $141.25 | $169.82 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $190.55 | Professional | None | $95.50 | $138.04 | $190.55 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $218.78 | Professional | None | $89.13 | $125.89 | $218.78 |
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 $48.98 Median $51.29 Typical High $69.18 | Professional | 52 · Reduced service | $48.98 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $20.42 Typical High $27.54 | Professional | 53 · Discontinued | $19.50 | $20.42 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $75.86 Typical High $104.71 | Professional | 54 · Surgery only | $72.44 | $75.86 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.14 Typical High $20.89 | Professional | 55 · Aftercare only | $14.45 | $15.14 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.23 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.77 | $10.23 | $13.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $66.07 Median $77.62 Typical High $97.72 | Professional | 51 · Multiple procedures | $66.07 | $77.62 | $97.72 |
Where South Carolina sits
The same service costs 3.7 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· 34th of 51
$129
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.