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 $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $257.04 | Professional | None | $245.47 | $251.19 | $257.04 |
BCBS South Carolina Setting Facility Modifier None Typical Low $190.55 Median $275.42 Typical High $524.81 | Facility | None | $190.55 | $275.42 | $524.81 |
BCBS South Carolina Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $309.03 | Professional | None | $269.15 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $512.86 Typical High $660.69 | Facility | None | $380.19 | $512.86 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Medcost Setting Facility Modifier None Typical Low $251.19 Median $295.12 Typical High $549.54 | Facility | None | $251.19 | $295.12 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $316.23 | Professional | None | $190.55 | $190.55 | $316.23 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $263.03 | Professional | None | $213.80 | $251.19 | $263.03 |
United Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $257.04 | Professional | None | $218.78 | $257.04 | $257.04 |
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 $123.03 Median $125.89 Typical High $128.82 | Professional | 52 · Reduced service | $123.03 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $50.12 Typical High $51.29 | Professional | 53 · Discontinued | $48.98 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $37.15 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.12 Typical High $25.70 | Professional | 56 · Pre-op care only | $24.55 | $25.12 | $25.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 51 · Multiple procedures | $95.50 | $95.50 | $95.50 |
Where South Carolina sits
The same service costs 1.7 times more in Alaska than in Indiana. 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· 9th of 51
$269
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.