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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $181.97 Typical High $181.97 | Professional | None | $173.78 | $181.97 | $181.97 |
BCBS South Carolina Setting Facility Modifier None Typical Low $100.00 Median $158.49 Typical High $275.42 | Facility | None | $100.00 | $158.49 | $275.42 |
BCBS South Carolina Setting Professional Modifier None Typical Low $173.78 Median $177.83 Typical High $190.55 | Professional | None | $173.78 | $177.83 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $302.00 Typical High $426.58 | Facility | None | $245.47 | $302.00 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $218.78 Typical High $436.52 | Facility | None | $181.97 | $218.78 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $173.78 | Professional | None | $109.65 | $109.65 | $173.78 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $398.11 Typical High $416.87 | Professional | None | $30.20 | $398.11 | $416.87 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $371.54 | Facility | None | $173.78 | $173.78 | $371.54 |
United Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $173.78 | Professional | None | $131.83 | $162.18 | $173.78 |
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 $87.10 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $87.10 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $34.67 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 54 · Surgery only | $128.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $25.70 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $17.38 | $18.20 | $18.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $53.70 Median $53.70 Typical High $102.33 | Professional | 51 · Multiple procedures | $53.70 | $53.70 | $102.33 |
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· 23rd of 51
$174
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.