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 $204.17 Median $5,623.41 Typical High $21,877.62 | Facility | None | $204.17 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | None | $173.78 | $204.17 | $204.17 |
BCBS South Carolina Setting Facility Modifier None Typical Low $977.24 Median $1,621.81 Typical High $3,019.95 | Facility | None | $977.24 | $1,621.81 | $3,019.95 |
BCBS South Carolina Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $251.19 | Professional | None | $151.36 | $194.98 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $223.87 Typical High $2,290.87 | Facility | None | $186.21 | $223.87 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $316.23 | Professional | None | $181.97 | $204.17 | $316.23 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $316.23 Typical High $478.63 | Facility | None | $199.53 | $316.23 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $234.42 | Professional | None | $181.97 | $213.80 | $234.42 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $338.84 | Professional | None | $158.49 | $239.88 | $338.84 |
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 $165.96 Median $208.93 Typical High $354.81 | Professional | None | $165.96 | $208.93 | $354.81 |
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 $87.10 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $87.10 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $34.67 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $128.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $25.70 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $17.38 | $20.42 | $20.42 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $91.20 Median $109.65 Typical High $154.88 | Professional | 51 · Multiple procedures | $91.20 | $109.65 | $154.88 |
Where South Carolina sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 44th of 51
$204
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.