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 $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $13.18 Typical High $13.18 | Professional | None | $12.30 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.17 Median $6.61 Typical High $6.61 | Professional | 52 · Reduced service | $6.17 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.63 Typical High $2.63 | Professional | 53 · Discontinued | $2.51 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.95 Typical High $1.95 | Professional | 55 · Aftercare only | $1.86 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.32 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.23 | $1.32 | $1.32 |
BCBS South Carolina Setting Facility Modifier None Typical Low $102.33 Median $173.78 Typical High $288.40 | Facility | None | $102.33 | $173.78 | $288.40 |
BCBS South Carolina Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $199.53 Typical High $199.53 | Professional | None | $14.45 | $199.53 | $199.53 |
Medcost Setting Facility Modifier None Typical Low $13.18 Median $15.49 Typical High $302.00 | Facility | None | $13.18 | $15.49 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $14.79 Median $302.00 Typical High $316.23 | Professional | None | $14.79 | $302.00 | $316.23 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Facility Modifier None Typical Low $158.49 Median $190.55 Typical High $251.19 | Facility | None | $158.49 | $190.55 | $251.19 |
United Setting Professional Modifier None Typical Low $10.00 Median $12.59 Typical High $138.04 | Professional | None | $10.00 | $12.59 | $138.04 |
1 more rate 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $9.12 Median $151.36 Typical High $158.49 | Professional | 51 · Multiple procedures | $9.12 | $151.36 | $158.49 |
Where South Carolina sits
The same service costs 43.7 times more in Hawaii 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· 2nd 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.