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 $81.28 Median $95.50 Typical High $21,877.62 | Facility | None | $81.28 | $95.50 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $95.50 | Professional | None | $74.13 | $81.28 | $95.50 |
BCBS South Carolina Setting Facility Modifier None Typical Low $331.13 Median $588.84 Typical High $1,000.00 | Facility | None | $331.13 | $588.84 | $1,000.00 |
BCBS South Carolina Setting Professional Modifier None Typical Low $53.70 Median $75.86 Typical High $128.82 | Professional | None | $53.70 | $75.86 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $56.23 Typical High $131.83 | Facility | None | $42.66 | $56.23 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $74.13 Typical High $138.04 | Professional | None | $61.66 | $74.13 | $138.04 |
Medcost Setting Facility Modifier None Typical Low $57.54 Median $102.33 Typical High $138.04 | Facility | None | $57.54 | $102.33 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $104.71 | Professional | None | $61.66 | $87.10 | $104.71 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $125.89 | Professional | None | $64.57 | $97.72 | $125.89 |
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 $58.88 Median $75.86 Typical High $138.04 | Professional | None | $58.88 | $75.86 | $138.04 |
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 $39.81 Median $39.81 Typical High $47.86 | Professional | 52 · Reduced service | $39.81 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $19.05 | Professional | 53 · Discontinued | $16.22 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $60.26 Typical High $72.44 | Professional | 54 · Surgery only | $60.26 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $14.45 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $9.55 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $91.20 Median $154.88 Typical High $165.96 | Professional | 50 · Both sides | $91.20 | $154.88 | $165.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.20 Median $52.48 Typical High $54.95 | Professional | 51 · Multiple procedures | $30.20 | $52.48 | $54.95 |
Where South Carolina sits
The same service costs 3.8 times more in Alaska than in Florida. 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· 35th of 51
$81.28
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.