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 $138.04 Median $323.59 Typical High $10,000.00 | Facility | None | $138.04 | $323.59 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $295.12 | Professional | None | $138.04 | $234.42 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
BCBS South Carolina Setting Facility Modifier None Typical Low $977.24 Median $1,737.80 Typical High $3,162.28 | Facility | None | $977.24 | $1,737.80 | $3,162.28 |
BCBS South Carolina Setting Professional Modifier None Typical Low $97.72 Median $229.09 Typical High $398.11 | Professional | None | $97.72 | $229.09 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $269.15 Typical High $407.38 | Professional | None | $165.96 | $269.15 | $407.38 |
Medcost Setting Facility Modifier None Typical Low $138.04 Median $269.15 Typical High $398.11 | Facility | None | $138.04 | $269.15 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $407.38 | Professional | None | $288.40 | $323.59 | $407.38 |
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 $117.49 Median $239.88 Typical High $436.52 | Professional | None | $117.49 | $239.88 | $436.52 |
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 $67.61 Median $102.33 Typical High $147.91 | Professional | 52 · Reduced service | $67.61 | $102.33 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $40.74 Typical High $60.26 | Professional | 53 · Discontinued | $26.92 | $40.74 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $154.88 Typical High $223.87 | Professional | 54 · Surgery only | $102.33 | $154.88 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $30.90 Typical High $44.67 | Professional | 55 · Aftercare only | $20.42 | $30.90 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $20.42 Typical High $29.51 | Professional | 56 · Pre-op care only | $13.49 | $20.42 | $29.51 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $158.49 Typical High $371.54 | Professional | 51 · Multiple procedures | $158.49 | $158.49 | $371.54 |
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· 19th 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.