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 $154.88 Median $4,897.79 Typical High $21,877.62 | Facility | None | $154.88 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $208.93 | Professional | None | $154.88 | $162.18 | $208.93 |
BCBS South Carolina Setting Facility Modifier None Typical Low $575.44 Median $1,000.00 Typical High $1,737.80 | Facility | None | $575.44 | $1,000.00 | $1,737.80 |
BCBS South Carolina Setting Professional Modifier None Typical Low $112.20 Median $208.93 Typical High $275.42 | Professional | None | $112.20 | $208.93 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $128.82 Typical High $724.44 | Facility | None | $75.86 | $128.82 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $295.12 | Professional | None | $177.83 | $229.09 | $295.12 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $186.21 Typical High $281.84 | Facility | None | $95.50 | $186.21 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $251.19 | Professional | None | $204.17 | $229.09 | $251.19 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $346.74 | Professional | None | $186.21 | $239.88 | $346.74 |
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 $120.23 Median $169.82 Typical High $302.00 | Professional | None | $120.23 | $169.82 | $302.00 |
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 $77.62 Median $79.43 Typical High $104.71 | Professional | 52 · Reduced service | $77.62 | $79.43 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $31.62 Typical High $42.66 | Professional | 53 · Discontinued | $30.90 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $120.23 Typical High $158.49 | Professional | 54 · Surgery only | $117.49 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.99 Typical High $31.62 | Professional | 55 · Aftercare only | $23.44 | $23.99 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.85 Typical High $20.89 | Professional | 56 · Pre-op care only | $15.49 | $15.85 | $20.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $114.82 Median $114.82 Typical High $158.49 | Professional | 51 · Multiple procedures | $114.82 | $114.82 | $158.49 |
Where South Carolina sits
The same service costs 3.6 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· 22nd of 51
$214
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.