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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | None | $389.05 | $407.38 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $467.74 | Professional | None | $426.58 | $426.58 | $467.74 |
BCBS South Carolina Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $588.84 | Facility | None | $194.98 | $316.23 | $588.84 |
BCBS South Carolina Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $489.78 | Professional | None | $389.05 | $426.58 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | None | $389.05 | $389.05 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $467.74 Typical High $1,148.15 | Facility | None | $208.93 | $467.74 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $407.38 | Professional | None | $91.20 | $91.20 | $407.38 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $331.13 | Professional | None | $295.12 | $331.13 | $331.13 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $831.76 | Facility | None | $389.05 | $389.05 | $831.76 |
United Setting Professional Modifier None Typical Low $154.88 Median $389.05 Typical High $389.05 | Professional | None | $154.88 | $389.05 | $389.05 |
5 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 $199.53 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $199.53 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $79.43 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $39.81 | $40.74 | $40.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $45.71 Median $45.71 Typical High $100.00 | Professional | 51 · Multiple procedures | $45.71 | $45.71 | $100.00 |
Where South Carolina sits
The same service costs 1.7 times more in Alaska than in Oklahoma. 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· 6th of 51
$427
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.