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 $707.95 Median $13,182.57 Typical High $22,908.68 | Facility | None | $707.95 | $13,182.57 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $707.95 | Professional | None | $602.56 | $707.95 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,737.80 Median $2,951.21 Typical High $17,782.79 | Facility | None | $1,737.80 | $2,951.21 | $17,782.79 |
BCBS South Carolina Setting Professional Modifier None Typical Low $537.03 Median $1,047.13 Typical High $1,380.38 | Professional | None | $537.03 | $1,047.13 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $11,220.18 Typical High $15,848.93 | Facility | None | $602.56 | $11,220.18 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,348.96 | Professional | None | $676.08 | $794.33 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $954.99 Typical High $12,302.69 | Facility | None | $676.08 | $954.99 | $12,302.69 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $891.25 | Professional | None | $602.56 | $851.14 | $891.25 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $549.54 Typical High $912.01 | Professional | None | $66.07 | $549.54 | $912.01 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,318.26 | Professional | None | $602.56 | $758.58 | $1,318.26 |
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 $302.00 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $302.00 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $446.68 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $89.13 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $60.26 | $70.79 | $70.79 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,288.25 Typical High $1,737.80 | Professional | 50 · Both sides | $1,174.90 | $1,288.25 | $1,737.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $389.05 Median $426.58 Typical High $575.44 | Professional | 51 · Multiple procedures | $389.05 | $426.58 | $575.44 |
Where South Carolina sits
The same service costs 11.7 times more in Oklahoma 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· 42nd of 51
$708
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.