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 $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $741.31 | Professional | None | $616.60 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $309.03 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $93.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $61.66 | $74.13 | $74.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $5,888.44 | Facility | None | $1,778.28 | $2,187.76 | $5,888.44 |
BCBS South Carolina Setting Professional Modifier None Typical Low $141.25 Median $144.54 Typical High $239.88 | Professional | None | $141.25 | $144.54 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $741.31 Typical High $954.99 | Facility | None | $123.03 | $741.31 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $204.17 Typical High $851.14 | Professional | None | $199.53 | $204.17 | $851.14 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Facility Modifier None Typical Low $8,709.64 Median $10,471.29 Typical High $13,803.84 | Facility | None | $8,709.64 | $10,471.29 | $13,803.84 |
United Setting Professional Modifier None Typical Low $67.61 Median $125.89 Typical High $269.15 | Professional | None | $67.61 | $125.89 | $269.15 |
1 more rate 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $100.00 Median $102.33 Typical High $524.81 | Professional | 51 · Multiple procedures | $100.00 | $102.33 | $524.81 |
Where South Carolina sits
The same service costs 7.6 times more in Colorado than in Rhode Island. 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· 28th of 51
$200
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.