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 $58.88 Median $4,897.79 Typical High $21,877.62 | Facility | None | $58.88 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $64.57 Typical High $79.43 | Professional | None | $50.12 | $64.57 | $79.43 |
BCBS South Carolina Setting Facility Modifier None Typical Low $489.78 Median $831.76 Typical High $1,479.11 | Facility | None | $489.78 | $831.76 | $1,479.11 |
BCBS South Carolina Setting Professional Modifier None Typical Low $37.15 Median $61.66 Typical High $77.62 | Professional | None | $37.15 | $61.66 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $63.10 Typical High $707.95 | Facility | None | $28.84 | $63.10 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $77.62 Typical High $120.23 | Professional | None | $64.57 | $77.62 | $120.23 |
Medcost Setting Facility Modifier None Typical Low $50.12 Median $77.62 Typical High $112.20 | Facility | None | $50.12 | $77.62 | $112.20 |
Medcost Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $112.20 | Professional | None | $53.70 | $67.61 | $112.20 |
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 $52.48 Median $70.79 Typical High $134.90 | Professional | None | $52.48 | $70.79 | $134.90 |
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 $29.51 Median $29.51 Typical High $32.36 | Professional | 52 · Reduced service | $29.51 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $12.88 | Professional | 53 · Discontinued | $11.75 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $44.67 Typical High $48.98 | Professional | 54 · Surgery only | $44.67 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $9.77 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $6.46 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $81.28 Median $109.65 Typical High $169.82 | Professional | 50 · Both sides | $81.28 | $109.65 | $169.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.92 Median $37.15 Typical High $56.23 | Professional | 51 · Multiple procedures | $26.92 | $37.15 | $56.23 |
Where South Carolina sits
The same service costs 3.6 times more in Wyoming 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· 33rd of 51
$74.13
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.