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 $141.25 Median $4,897.79 Typical High $21,877.62 | Facility | None | $141.25 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $309.03 | Professional | None | $138.04 | $223.87 | $309.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,905.46 | $3,311.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $100.00 Median $234.42 Typical High $371.54 | Professional | None | $100.00 | $234.42 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $416.87 | Professional | None | $169.82 | $275.42 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $275.42 Typical High $416.87 | Facility | None | $141.25 | $275.42 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $416.87 | Professional | None | $295.12 | $338.84 | $416.87 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $436.52 | Professional | None | $234.42 | $302.00 | $436.52 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,073.80 Typical High $7,762.47 | Facility | None | $1,202.26 | $4,073.80 | $7,762.47 |
United Setting Professional Modifier None Typical Low $120.23 Median $251.19 Typical High $457.09 | Professional | None | $120.23 | $251.19 | $457.09 |
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 $69.18 Median $107.15 Typical High $151.36 | Professional | 52 · Reduced service | $69.18 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $43.65 Typical High $61.66 | Professional | 53 · Discontinued | $27.54 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $162.18 Typical High $229.09 | Professional | 54 · Surgery only | $102.33 | $162.18 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $32.36 Typical High $45.71 | Professional | 55 · Aftercare only | $20.89 | $32.36 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $21.88 Typical High $30.90 | Professional | 56 · Pre-op care only | $13.80 | $21.88 | $30.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $169.82 Typical High $380.19 | Professional | 51 · Multiple procedures | $169.82 | $169.82 | $380.19 |
Where South Carolina sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 21st of 51
$275
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.