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 $56.23 Median $120.23 Typical High $9,772.37 | Facility | None | $56.23 | $120.23 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $85.11 Typical High $141.25 | Professional | None | $56.23 | $85.11 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $23.44 Median $100.00 Typical High $169.82 | Professional | None | $23.44 | $100.00 | $169.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $97.72 Median $407.38 Typical High $1,412.54 | Facility | None | $97.72 | $407.38 | $1,412.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $138.04 | Professional | None | $74.13 | $104.71 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $794.33 | Facility | None | $52.48 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $173.78 | Professional | None | $57.54 | $89.13 | $173.78 |
Medcost Setting Facility Modifier None Typical Low $52.48 Median $87.10 Typical High $524.81 | Facility | None | $52.48 | $87.10 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $147.91 | Professional | None | $93.33 | $125.89 | $147.91 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $44.67 Typical High $93.33 | Professional | None | $21.88 | $44.67 | $93.33 |
United Setting Facility Modifier None Typical Low $83.18 Median $426.58 Typical High $2,238.72 | Facility | None | $83.18 | $426.58 | $2,238.72 |
United Setting Professional Modifier None Typical Low $51.29 Median $87.10 Typical High $151.36 | Professional | None | $51.29 | $87.10 | $151.36 |
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 $27.54 Median $33.88 Typical High $60.26 | Professional | 52 · Reduced service | $27.54 | $33.88 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.80 Typical High $23.99 | Professional | 53 · Discontinued | $10.96 | $13.80 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $51.29 Typical High $91.20 | Professional | 54 · Surgery only | $41.69 | $51.29 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.23 Typical High $18.20 | Professional | 55 · Aftercare only | $8.32 | $10.23 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.92 Typical High $12.02 | Professional | 56 · Pre-op care only | $5.50 | $6.92 | $12.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $46.77 Median $66.07 Typical High $79.43 | Professional | 51 · Multiple procedures | $46.77 | $66.07 | $79.43 |
Where South Carolina sits
The same service costs 3.2 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· 41st of 51
$93.33
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.