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 $46.77 Median $46.77 Typical High $134.90 | Facility | None | $46.77 | $46.77 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $104.71 Typical High $134.90 | Professional | None | $46.77 | $104.71 | $134.90 |
BCBS South Carolina Setting Facility Modifier None Typical Low $141.25 Median $338.84 Typical High $776.25 | Facility | None | $141.25 | $338.84 | $776.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $36.31 Median $64.57 Typical High $123.03 | Professional | None | $36.31 | $64.57 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $1,412.54 | Facility | None | $660.69 | $660.69 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $114.82 Typical High $162.18 | Professional | None | $43.65 | $114.82 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $251.19 | Professional | None | $190.55 | $204.17 | $251.19 |
Medcost Setting Facility Modifier None Typical Low $46.77 Median $123.03 Typical High $181.97 | Facility | None | $46.77 | $123.03 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $177.83 | Professional | None | $97.72 | $147.91 | $177.83 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $245.47 | Professional | None | $123.03 | $158.49 | $245.47 |
United Setting Facility Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,412.54 | Facility | None | $891.25 | $1,096.48 | $1,412.54 |
United Setting Professional Modifier None Typical Low $39.81 Median $91.20 Typical High $158.49 | Professional | None | $39.81 | $91.20 | $158.49 |
5 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 $23.44 Median $40.74 Typical High $67.61 | Professional | 52 · Reduced service | $23.44 | $40.74 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $15.85 Typical High $26.92 | Professional | 53 · Discontinued | $9.33 | $15.85 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $11.75 Typical High $19.95 | Professional | 55 · Aftercare only | $7.08 | $11.75 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.94 Typical High $13.49 | Professional | 56 · Pre-op care only | $4.68 | $7.94 | $13.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $81.28 Typical High $95.50 | Professional | 51 · Multiple procedures | $48.98 | $81.28 | $95.50 |
Where South Carolina sits
The same service costs 3.5 times more in Wisconsin than in Washington, DC. 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· 28th of 51
$115
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.