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 $89.13 Median $89.13 Typical High $109.65 | Facility | None | $89.13 | $89.13 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | None | $81.28 | $89.13 | $89.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $131.83 Median $213.80 Typical High $389.05 | Facility | None | $131.83 | $213.80 | $389.05 |
BCBS South Carolina Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $63.10 | Professional | None | $60.26 | $60.26 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $26.92 Typical High $69.18 | Professional | None | $26.30 | $26.92 | $69.18 |
Medcost Setting Facility Modifier None Typical Low $15.14 Median $89.13 Typical High $120.23 | Facility | None | $15.14 | $89.13 | $120.23 |
Medcost Setting Professional Modifier None Typical Low $22.91 Median $44.67 Typical High $97.72 | Professional | None | $22.91 | $44.67 | $97.72 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,348.96 | Facility | None | $851.14 | $1,023.29 | $1,348.96 |
United Setting Professional Modifier None Typical Low $30.90 Median $61.66 Typical High $79.43 | Professional | None | $30.90 | $61.66 | $79.43 |
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 $43.65 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $17.38 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $66.07 Typical High $66.07 | Professional | 54 · Surgery only | $64.57 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $8.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $11.48 Median $22.39 Typical High $61.66 | Professional | 51 · Multiple procedures | $11.48 | $22.39 | $61.66 |
Where South Carolina sits
The same service costs 4.5 times more in Alaska than in Ohio. 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
$79.43
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.