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 $190.55 Median $9,120.11 Typical High $22,908.68 | Facility | None | $190.55 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $208.93 | Professional | None | $181.97 | $190.55 | $208.93 |
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 $169.82 Median $257.04 Typical High $407.38 | Professional | None | $169.82 | $257.04 | $407.38 |
Medcost Setting Facility Modifier None Typical Low $177.83 Median $208.93 Typical High $1,995.26 | Facility | None | $177.83 | $208.93 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $173.78 Typical High $281.84 | Professional | None | $169.82 | $173.78 | $281.84 |
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 $91.20 Median $95.50 Typical High $104.71 | Professional | 52 · Reduced service | $91.20 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.02 Typical High $41.69 | Professional | 53 · Discontinued | $36.31 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $144.54 Typical High $158.49 | Professional | 54 · Surgery only | $138.04 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.84 Typical High $31.62 | Professional | 55 · Aftercare only | $27.54 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.05 Typical High $20.89 | Professional | 56 · Pre-op care only | $18.20 | $19.05 | $20.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $85.11 Median $85.11 Typical High $186.21 | Professional | 51 · Multiple procedures | $85.11 | $85.11 | $186.21 |
Where South Carolina sits
The same service costs 25.7 times more in Oklahoma than in Vermont. 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· 14th of 51
$407
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.