How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $109.65 | Professional | None | $107.15 | $109.65 | $109.65 |
BCBS South Carolina Setting Facility Modifier None Typical Low $229.09 Median $724.44 Typical High $1,122.02 | Facility | None | $229.09 | $724.44 | $1,122.02 |
BCBS South Carolina Setting Professional Modifier None Typical Low $104.71 Median $204.17 Typical High $208.93 | Professional | None | $104.71 | $204.17 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $181.97 Typical High $257.04 | Facility | None | $147.91 | $181.97 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $147.91 Typical High $446.68 | Facility | None | $109.65 | $147.91 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $467.74 | Professional | None | $263.03 | $354.81 | $467.74 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $218.78 Typical High $302.00 | Professional | None | $30.20 | $218.78 | $302.00 |
United Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $223.87 | Facility | None | $104.71 | $104.71 | $223.87 |
United Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $128.82 | Professional | None | $95.50 | $123.03 | $128.82 |
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 $52.48 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $52.48 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $21.38 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $15.85 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.72 | $10.96 | $10.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $229.09 Typical High $776.25 | Professional | 51 · Multiple procedures | $165.96 | $229.09 | $776.25 |
Where South Carolina sits
The same service costs 1.9 times more in Wyoming than in Vermont. 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· 9th of 51
$129
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.