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 $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,570.40 | $2,691.53 | $2,691.53 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,737.80 Median $2,884.03 Typical High $4,897.79 | Facility | None | $1,737.80 | $2,884.03 | $4,897.79 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2,570.40 Median $2,630.27 Typical High $3,019.95 | Professional | None | $2,570.40 | $2,630.27 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $2,884.03 Median $4,168.69 Typical High $6,309.57 | Facility | None | $2,884.03 | $4,168.69 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Medcost Setting Facility Modifier None Typical Low $2,691.53 Median $3,235.94 Typical High $6,760.83 | Facility | None | $2,691.53 | $3,235.94 | $6,760.83 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,737.80 | $1,737.80 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $5,888.44 Typical High $6,165.95 | Professional | None | $30.20 | $5,888.44 | $6,165.95 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $5,495.41 | Facility | None | $2,570.40 | $2,570.40 | $5,495.41 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $2,511.89 Typical High $2,570.40 | Professional | None | $1,949.84 | $2,511.89 | $2,570.40 |
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 $1,258.93 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,258.93 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $512.86 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,905.46 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $380.19 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $257.04 | $269.15 | $269.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $870.96 Median $870.96 Typical High $1,698.24 | Professional | 51 · Multiple procedures | $870.96 | $870.96 | $1,698.24 |
Where South Carolina sits
Rates are fairly even across states for this service. 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· 40th of 51
$2,570
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.