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 $64.57 Median $4,897.79 Typical High $21,877.62 | Facility | None | $64.57 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $123.03 Typical High $154.88 | Professional | None | $64.57 | $123.03 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
BCBS South Carolina Setting Facility Modifier None Typical Low $489.78 Median $794.33 Typical High $1,621.81 | Facility | None | $489.78 | $794.33 | $1,621.81 |
BCBS South Carolina Setting Professional Modifier None Typical Low $47.86 Median $141.25 Typical High $177.83 | Professional | None | $47.86 | $141.25 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $213.80 Typical High $707.95 | Facility | None | $95.50 | $213.80 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $186.21 | Professional | None | $104.71 | $147.91 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $79.43 Median $123.03 Typical High $154.88 | Facility | None | $79.43 | $123.03 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $199.53 | Professional | None | $125.89 | $158.49 | $199.53 |
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 $302.00 Median $1,122.02 Typical High $6,025.60 | Facility | None | $302.00 | $1,122.02 | $6,025.60 |
United Setting Professional Modifier None Typical Low $48.98 Median $109.65 Typical High $190.55 | Professional | None | $48.98 | $109.65 | $190.55 |
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 $32.36 Median $45.71 Typical High $64.57 | Professional | 52 · Reduced service | $32.36 | $45.71 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $18.20 Typical High $25.70 | Professional | 53 · Discontinued | $12.88 | $18.20 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $69.18 Typical High $95.50 | Professional | 54 · Surgery only | $47.86 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.80 Typical High $19.05 | Professional | 55 · Aftercare only | $9.77 | $13.80 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $9.12 Typical High $12.88 | Professional | 56 · Pre-op care only | $6.46 | $9.12 | $12.88 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $234.42 Typical High $316.23 | Professional | 50 · Both sides | $208.93 | $234.42 | $316.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $79.43 Typical High $104.71 | Professional | 51 · Multiple procedures | $69.18 | $79.43 | $104.71 |
Where South Carolina sits
The same service costs 3.2 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· 13th of 51
$148
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.