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 $42.66 Median $51.29 Typical High $21,877.62 | Facility | None | $42.66 | $51.29 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $42.66 Typical High $51.29 | Professional | None | $37.15 | $42.66 | $51.29 |
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 $28.18 Median $52.48 Typical High $204.17 | Professional | None | $28.18 | $52.48 | $204.17 |
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 $28.18 Median $39.81 Typical High $70.79 | Professional | None | $28.18 | $39.81 | $70.79 |
Medcost Setting Facility Modifier None Typical Low $25.70 Median $39.81 Typical High $57.54 | Facility | None | $25.70 | $39.81 | $57.54 |
Medcost Setting Professional Modifier None Typical Low $43.65 Median $46.77 Typical High $57.54 | Professional | None | $43.65 | $46.77 | $57.54 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $47.86 Typical High $63.10 | Professional | None | $30.90 | $47.86 | $63.10 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $31.62 Median $40.74 Typical High $72.44 | Professional | None | $31.62 | $40.74 | $72.44 |
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 $21.38 Median $21.38 Typical High $25.70 | Professional | 52 · Reduced service | $21.38 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $10.23 | Professional | 53 · Discontinued | $8.51 | $8.51 | $10.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $31.62 Typical High $38.90 | Professional | 54 · Surgery only | $31.62 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $7.76 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $5.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $66.07 Median $74.13 Typical High $95.50 | Professional | 50 · Both sides | $66.07 | $74.13 | $95.50 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $21.88 Median $24.55 Typical High $32.36 | Professional | 51 · Multiple procedures | $21.88 | $24.55 | $32.36 |
Where South Carolina sits
The same service costs 3.8 times more in Alaska than in Utah. 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· 25th of 51
$51.29
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.