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 $61.66 Median $4,265.80 Typical High $16,595.87 | Facility | None | $61.66 | $4,265.80 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $125.89 | Professional | None | $61.66 | $87.10 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $44.67 Median $69.18 Typical High $74.13 | Professional | None | $44.67 | $69.18 | $74.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $489.78 Median $794.33 Typical High $1,584.89 | Facility | None | $489.78 | $794.33 | $1,584.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $44.67 Median $117.49 Typical High $177.83 | Professional | None | $44.67 | $117.49 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $102.33 Typical High $707.95 | Facility | None | $46.77 | $102.33 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $141.25 | Professional | None | $79.43 | $109.65 | $141.25 |
Medcost Setting Facility Modifier None Typical Low $63.10 Median $97.72 Typical High $114.82 | Facility | None | $63.10 | $97.72 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $162.18 | Professional | None | $85.11 | $131.83 | $162.18 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $117.49 | Professional | None | $64.57 | $79.43 | $117.49 |
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 $47.86 Median $77.62 Typical High $151.36 | Professional | None | $47.86 | $77.62 | $151.36 |
8 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 $30.90 Median $33.11 Typical High $43.65 | Professional | 52 · Reduced service | $30.90 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.18 Typical High $17.38 | Professional | 53 · Discontinued | $12.30 | $13.18 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $48.98 Typical High $64.57 | Professional | 54 · Surgery only | $45.71 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.77 Typical High $13.18 | Professional | 55 · Aftercare only | $9.33 | $9.77 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.61 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.17 | $6.61 | $8.71 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $112.20 Typical High $123.03 | Professional | 50 · Both sides | $102.33 | $112.20 | $123.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $144.54 Median $194.98 Typical High $245.47 | Professional | 50 · Both sides | $144.54 | $194.98 | $245.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $66.07 Typical High $81.28 | Professional | 51 · Multiple procedures | $48.98 | $66.07 | $81.28 |
Where South Carolina sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 13th of 51
$105
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.