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 $144.54 Median $9,120.11 Typical High $22,908.68 | Facility | None | $144.54 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | None | $123.03 | $144.54 | $144.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $199.53 | Professional | None | $109.65 | $128.82 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $1,905.46 | Facility | None | $588.84 | $851.14 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $158.49 Typical High $275.42 | Professional | None | $138.04 | $158.49 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $144.54 Typical High $338.84 | Facility | None | $109.65 | $144.54 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $177.83 | Professional | None | $141.25 | $158.49 | $177.83 |
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 $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $251.19 | Professional | None | $114.82 | $144.54 | $251.19 |
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 $60.26 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $60.26 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $24.55 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $109.65 Typical High $109.65 | Professional | 54 · Surgery only | $91.20 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $18.20 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.30 | $14.45 | $14.45 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $87.10 Typical High $109.65 | Professional | 51 · Multiple procedures | $74.13 | $87.10 | $109.65 |
Where South Carolina sits
The same service costs 3.9 times more in Alaska than in Utah. 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
$155
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.