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 $8,709.64 Median $8,709.64 Typical High $8,709.64 | Facility | None | $8,709.64 | $8,709.64 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $8,511.38 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,511.38 | $8,709.64 | $8,709.64 |
BCBS South Carolina Setting Facility Modifier None Typical Low $812.83 Median $4,466.84 Typical High $8,912.51 | Facility | None | $812.83 | $4,466.84 | $8,912.51 |
BCBS South Carolina Setting Professional Modifier None Typical Low $6,918.31 Median $7,413.10 Typical High $8,912.51 | Professional | None | $6,918.31 | $7,413.10 | $8,912.51 |
Cigna Setting Facility Modifier None Typical Low $12,589.25 Median $17,378.01 Typical High $21,877.62 | Facility | None | $12,589.25 | $17,378.01 | $21,877.62 |
Cigna Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $309.03 | Professional | None | $295.12 | $309.03 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $8,709.64 Median $10,232.93 Typical High $11,748.98 | Facility | None | $8,709.64 | $10,232.93 | $11,748.98 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $707.95 | Professional | None | $223.87 | $309.03 | $707.95 |
Molina Setting Professional Modifier None Typical Low $7,413.10 Median $8,317.64 Typical High $8,709.64 | Professional | None | $7,413.10 | $8,317.64 | $8,709.64 |
United Setting Professional Modifier None Typical Low $7,079.46 Median $8,709.64 Typical High $9,332.54 | Professional | None | $7,079.46 | $8,709.64 | $9,332.54 |
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 $4,265.80 Median $4,365.16 Typical High $4,365.16 | Professional | 52 · Reduced service | $4,265.80 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,698.24 Median $1,737.80 Typical High $1,737.80 | Professional | 53 · Discontinued | $1,698.24 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,258.93 Median $1,288.25 Typical High $1,288.25 | Professional | 55 · Aftercare only | $1,258.93 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $851.14 Median $870.96 Typical High $870.96 | Professional | 56 · Pre-op care only | $851.14 | $870.96 | $870.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $112.20 Median $151.36 Typical High $281.84 | Professional | 51 · Multiple procedures | $112.20 | $151.36 | $281.84 |
Where South Carolina sits
The same service costs 26.3 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· 36th of 51
$8,710
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.