How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $389.05 | Professional | None | $354.81 | $389.05 | $389.05 |
BCBS South Carolina Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
BCBS South Carolina Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $416.87 | Professional | None | $302.00 | $323.59 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $426.58 Typical High $524.81 | Facility | None | $380.19 | $426.58 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $457.09 Typical High $457.09 | Professional | None | $162.18 | $457.09 | $457.09 |
United Setting Professional Modifier None Typical Low $141.25 Median $338.84 Typical High $407.38 | Professional | None | $141.25 | $338.84 | $407.38 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $53.70 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $35.48 | $38.90 | $38.90 |
Where South Carolina sits
The same service costs 3.2 times more in Iowa than in New York. 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· 29th of 51
$324
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.