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 $24.55 Median $27.54 Typical High $21,877.62 | Facility | None | $24.55 | $27.54 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $27.54 Typical High $67.61 | Professional | None | $24.55 | $27.54 | $67.61 |
BCBS South Carolina Setting Facility Modifier None Typical Low $147.91 Median $251.19 Typical High $446.68 | Facility | None | $147.91 | $251.19 | $446.68 |
BCBS South Carolina Setting Professional Modifier None Typical Low $18.20 Median $58.88 Typical High $100.00 | Professional | None | $18.20 | $58.88 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $794.33 | Facility | None | $52.48 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $51.29 Typical High $67.61 | Professional | None | $35.48 | $51.29 | $67.61 |
Medcost Setting Facility Modifier None Typical Low $26.92 Median $41.69 Typical High $60.26 | Facility | None | $26.92 | $41.69 | $60.26 |
Medcost Setting Professional Modifier None Typical Low $21.88 Median $60.26 Typical High $97.72 | Professional | None | $21.88 | $60.26 | $97.72 |
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 $23.44 Median $41.69 Typical High $81.28 | Professional | None | $23.44 | $41.69 | $81.28 |
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 $12.30 Median $12.30 Typical High $13.80 | Professional | 52 · Reduced service | $12.30 | $12.30 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $5.50 | Professional | 53 · Discontinued | $4.90 | $4.90 | $5.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $18.20 Typical High $20.89 | Professional | 54 · Surgery only | $18.20 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $4.17 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.75 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $41.69 Median $91.20 Typical High $147.91 | Professional | 50 · Both sides | $41.69 | $91.20 | $147.91 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $13.80 Median $30.20 Typical High $48.98 | Professional | 51 · Multiple procedures | $13.80 | $30.20 | $48.98 |
Where South Carolina sits
The same service costs 4.3 times more in Wyoming 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· 9th of 51
$53.70
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.