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 $158.49 Median $9,120.11 Typical High $22,908.68 | Facility | None | $158.49 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $158.49 Typical High $173.78 | Professional | None | $154.88 | $158.49 | $173.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $489.78 Median $870.96 Typical High $3,890.45 | Facility | None | $489.78 | $870.96 | $3,890.45 |
BCBS South Carolina Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $295.12 | Professional | None | $154.88 | $234.42 | $295.12 |
Medcost Setting Facility Modifier None Typical Low $151.36 Median $173.78 Typical High $1,995.26 | Facility | None | $151.36 | $173.78 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $147.91 Typical High $234.42 | Professional | None | $144.54 | $147.91 | $234.42 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
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 $77.62 Median $79.43 Typical High $87.10 | Professional | 52 · Reduced service | $77.62 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $31.62 Typical High $34.67 | Professional | 53 · Discontinued | $30.90 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $120.23 Typical High $131.83 | Professional | 54 · Surgery only | $117.49 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.99 Typical High $26.30 | Professional | 55 · Aftercare only | $23.44 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.85 Typical High $17.38 | Professional | 56 · Pre-op care only | $15.49 | $15.85 | $17.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $72.44 Typical High $158.49 | Professional | 51 · Multiple procedures | $72.44 | $72.44 | $158.49 |
Where South Carolina sits
The same service costs 7.6 times more in Nebraska than in West Virginia. 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· 12th of 51
$363
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.