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 $131.83 Median $5,623.41 Typical High $21,877.62 | Facility | None | $131.83 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $131.83 | Professional | None | $109.65 | $131.83 | $131.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,096.48 Median $1,905.46 Typical High $3,388.44 | Facility | None | $1,096.48 | $1,905.46 | $3,388.44 |
BCBS South Carolina Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $208.93 | Professional | None | $104.71 | $147.91 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $489.78 Typical High $794.33 | Facility | None | $426.58 | $489.78 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $257.04 | Professional | None | $123.03 | $141.25 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $131.83 Median $407.38 Typical High $537.03 | Facility | None | $131.83 | $407.38 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $186.21 | Professional | None | $125.89 | $151.36 | $186.21 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $275.42 | Professional | None | $125.89 | $190.55 | $275.42 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,025.60 | Facility | None | $302.00 | $1,122.02 | $6,025.60 |
United Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $218.78 | Professional | None | $102.33 | $131.83 | $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 $54.95 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $54.95 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $21.88 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $97.72 Typical High $97.72 | Professional | 54 · Surgery only | $81.28 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $16.22 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.96 | $13.18 | $13.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $67.61 Median $75.86 Typical High $100.00 | Professional | 51 · Multiple procedures | $67.61 | $75.86 | $100.00 |
Where South Carolina sits
The same service costs 4.4 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· 33rd of 51
$162
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.