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 $8.13 Median $9,120.11 Typical High $22,908.68 | Facility | None | $8.13 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $8.13 Typical High $8.13 | Professional | None | $7.76 | $8.13 | $8.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $131.83 Median $295.12 Typical High $416.87 | Facility | None | $131.83 | $295.12 | $416.87 |
BCBS South Carolina Setting Professional Modifier None Typical Low $8.13 Median $16.98 Typical High $28.84 | Professional | None | $8.13 | $16.98 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $11.75 Typical High $15.85 | Professional | None | $9.33 | $11.75 | $15.85 |
Medcost Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Medcost Setting Facility Modifier None Typical Low $8.13 Median $9.33 Typical High $21.38 | Facility | None | $8.13 | $9.33 | $21.38 |
Medcost Setting Professional Modifier None Typical Low $9.12 Median $12.02 Typical High $22.91 | Professional | None | $9.12 | $12.02 | $22.91 |
United Setting Facility Modifier None Typical Low $537.03 Median $660.69 Typical High $851.14 | Facility | None | $537.03 | $660.69 | $851.14 |
United Setting Professional Modifier None Typical Low $6.61 Median $9.12 Typical High $14.45 | Professional | None | $6.61 | $9.12 | $14.45 |
6 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 $3.89 Median $4.07 Typical High $4.07 | Professional | 52 · Reduced service | $3.89 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $1.62 Typical High $1.62 | Professional | 53 · Discontinued | $1.55 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.75 Median $6.03 Typical High $6.03 | Professional | 54 · Surgery only | $5.75 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.15 Median $1.20 Typical High $1.20 | Professional | 55 · Aftercare only | $1.15 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.81 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.78 | $0.81 | $0.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $4.90 Median $7.59 Typical High $11.48 | Professional | 51 · Multiple procedures | $4.90 | $7.59 | $11.48 |
Where South Carolina sits
The same service costs 2.3 times more in Hawaii than in North Carolina. 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· 19th of 51
$11.75
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.