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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | None | $245.47 | $257.04 | $257.04 |
BCBS South Carolina Setting Facility Modifier None Typical Low $181.97 Median $323.59 Typical High $602.56 | Facility | None | $181.97 | $323.59 | $602.56 |
BCBS South Carolina Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $302.00 | Professional | None | $263.03 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $489.78 Typical High $630.96 | Facility | None | $288.40 | $489.78 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $245.47 Median $302.00 Typical High $331.13 | Facility | None | $245.47 | $302.00 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $257.04 | Professional | None | $53.70 | $53.70 | $257.04 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $309.03 | Professional | None | $245.47 | $245.47 | $309.03 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $549.54 | Facility | None | $257.04 | $257.04 | $549.54 |
United Setting Professional Modifier None Typical Low $100.00 Median $251.19 Typical High $251.19 | Professional | None | $100.00 | $251.19 | $251.19 |
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 $123.03 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $123.03 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $48.98 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $37.15 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $24.55 | $25.70 | $25.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.92 Median $26.92 Typical High $85.11 | Professional | 51 · Multiple procedures | $26.92 | $26.92 | $85.11 |
Where South Carolina sits
The same service costs 4.1 times more in Alaska than in Montana. 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· 2nd of 51
$263
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.