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 $58.88 Median $177.83 Typical High $10,000.00 | Facility | None | $58.88 | $177.83 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $100.00 Typical High $128.82 | Professional | None | $58.88 | $100.00 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
BCBS South Carolina Setting Facility Modifier None Typical Low $354.81 Median $630.96 Typical High $1,148.15 | Facility | None | $354.81 | $630.96 | $1,148.15 |
BCBS South Carolina Setting Professional Modifier None Typical Low $44.67 Median $83.18 Typical High $154.88 | Professional | None | $44.67 | $83.18 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $223.87 Typical High $707.95 | Facility | None | $102.33 | $223.87 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $125.89 Typical High $177.83 | Professional | None | $72.44 | $125.89 | $177.83 |
Medcost Setting Facility Modifier None Typical Low $58.88 Median $131.83 Typical High $141.25 | Facility | None | $58.88 | $131.83 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $131.83 Typical High $181.97 | Professional | None | $125.89 | $131.83 | $181.97 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $229.09 | Professional | None | $128.82 | $154.88 | $229.09 |
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 $44.67 Median $93.33 Typical High $173.78 | Professional | None | $44.67 | $93.33 | $173.78 |
7 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 $29.51 Median $41.69 Typical High $64.57 | Professional | 52 · Reduced service | $29.51 | $41.69 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $16.60 Typical High $25.70 | Professional | 53 · Discontinued | $11.75 | $16.60 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $63.10 Typical High $97.72 | Professional | 54 · Surgery only | $43.65 | $63.10 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.59 Typical High $19.50 | Professional | 55 · Aftercare only | $8.71 | $12.59 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.32 Typical High $12.88 | Professional | 56 · Pre-op care only | $5.89 | $8.32 | $12.88 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $234.42 Typical High $316.23 | Professional | 50 · Both sides | $190.55 | $234.42 | $316.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $64.57 Median $79.43 Typical High $107.15 | Professional | 51 · Multiple procedures | $64.57 | $79.43 | $107.15 |
Where South Carolina sits
The same service costs 3.4 times more in Alaska than in Kentucky. 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· 14th of 51
$126
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.