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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | None | $281.84 | $295.12 | $295.12 |
BCBS South Carolina Setting Facility Modifier None Typical Low $83.18 Median $173.78 Typical High $302.00 | Facility | None | $83.18 | $173.78 | $302.00 |
BCBS South Carolina Setting Professional Modifier None Typical Low $275.42 Median $281.84 Typical High $302.00 | Professional | None | $275.42 | $281.84 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $489.78 Typical High $691.83 | Facility | None | $398.11 | $489.78 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $323.59 Typical High $691.83 | Facility | None | $123.03 | $323.59 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $281.84 | Professional | None | $100.00 | $100.00 | $281.84 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $645.65 Typical High $676.08 | Professional | None | $30.20 | $645.65 | $676.08 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $602.56 | Facility | None | $281.84 | $281.84 | $602.56 |
United Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $281.84 | Professional | None | $213.80 | $269.15 | $281.84 |
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 $138.04 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $138.04 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $56.23 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $41.69 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $28.18 | $29.51 | $29.51 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $48.98 Typical High $158.49 | Professional | 51 · Multiple procedures | $48.98 | $48.98 | $158.49 |
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· 42nd of 51
$282
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.