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 $208.93 Median $5,888.44 Typical High $21,877.62 | Facility | None | $208.93 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $208.93 | Professional | None | $177.83 | $208.93 | $208.93 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $977.24 Typical High $7,762.47 | Facility | None | $676.08 | $977.24 | $7,762.47 |
BCBS South Carolina Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $354.81 | Professional | None | $147.91 | $245.47 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $1,905.46 | Facility | None | $588.84 | $851.14 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $331.13 | Professional | None | $208.93 | $213.80 | $331.13 |
Medcost Setting Facility Modifier None Typical Low $173.78 Median $602.56 Typical High $851.14 | Facility | None | $173.78 | $602.56 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $275.42 | Professional | None | $204.17 | $239.88 | $275.42 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $288.40 | Professional | None | $158.49 | $204.17 | $288.40 |
United Setting Facility Modifier None Typical Low $83.18 Median $426.58 Typical High $2,238.72 | Facility | None | $83.18 | $426.58 | $2,238.72 |
United Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $309.03 | Professional | None | $147.91 | $190.55 | $309.03 |
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 $87.10 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $87.10 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $35.48 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $158.49 Typical High $158.49 | Professional | 54 · Surgery only | $131.83 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $26.30 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $17.78 | $20.89 | $20.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $112.20 Median $128.82 Typical High $158.49 | Professional | 51 · Multiple procedures | $112.20 | $128.82 | $158.49 |
Where South Carolina sits
The same service costs 4.5 times more in Alaska than in New York. 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· 23rd of 51
$245
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.