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 $123.03 Median $123.03 Typical High $158.49 | Facility | None | $123.03 | $123.03 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $169.82 | Professional | None | $123.03 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $63.10 Typical High $79.43 | Professional | 52 · Reduced service | $61.66 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.05 Typical High $23.99 | Professional | 55 · Aftercare only | $18.20 | $19.05 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.59 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.30 | $12.59 | $15.85 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $177.83 | Professional | None | $162.18 | $177.83 | $177.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $128.82 Median $134.90 Typical High $162.18 | Professional | None | $128.82 | $134.90 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $199.53 | Professional | None | $85.11 | $128.82 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $302.00 | Professional | None | $141.25 | $177.83 | $302.00 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $147.91 Typical High $190.55 | Facility | None | $123.03 | $147.91 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $186.21 | Professional | None | $125.89 | $147.91 | $186.21 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $114.82 Typical High $151.36 | Professional | None | $72.44 | $114.82 | $151.36 |
United Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $177.83 | Professional | None | $93.33 | $125.89 | $177.83 |
2 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 |
|---|---|---|---|---|---|
BCBS South Carolina Setting Professional Modifier 29 Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | 29 | $54.95 | $54.95 | $61.66 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $61.66 Median $74.13 Typical High $114.82 | Professional | 51 · Multiple procedures | $61.66 | $74.13 | $114.82 |
Where South Carolina sits
The same service costs 2.6 times more in Alaska 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· 43rd of 51
$132
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.