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 $28.84 Median $5,623.41 Typical High $21,877.62 | Facility | None | $28.84 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $32.36 Typical High $37.15 | Professional | None | $28.84 | $32.36 | $37.15 |
Ambetter Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
BCBS South Carolina Setting Facility Modifier None Typical Low $338.84 Median $512.86 Typical High $1,096.48 | Facility | None | $338.84 | $512.86 | $1,096.48 |
BCBS South Carolina Setting Professional Modifier None Typical Low $20.89 Median $37.15 Typical High $63.10 | Professional | None | $20.89 | $37.15 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $48.98 Typical High $977.24 | Facility | None | $18.20 | $48.98 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $45.71 Typical High $58.88 | Professional | None | $26.92 | $45.71 | $58.88 |
Medcost Setting Facility Modifier None Typical Low $22.91 Median $40.74 Typical High $48.98 | Facility | None | $22.91 | $40.74 | $48.98 |
Medcost Setting Professional Modifier None Typical Low $36.31 Median $48.98 Typical High $61.66 | Professional | None | $36.31 | $48.98 | $61.66 |
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 $21.88 Median $31.62 Typical High $63.10 | Professional | None | $21.88 | $31.62 | $63.10 |
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 $14.45 Median $14.45 Typical High $18.62 | Professional | 52 · Reduced service | $14.45 | $14.45 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $7.41 | Professional | 53 · Discontinued | $5.75 | $5.75 | $7.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $21.88 Typical High $28.18 | Professional | 54 · Surgery only | $21.38 | $21.88 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $5.62 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $3.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.91 Median $26.30 Typical High $30.90 | Professional | 51 · Multiple procedures | $22.91 | $26.30 | $30.90 |
Where South Carolina sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 34th of 51
$37.15
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.