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 $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | None | $229.09 | $239.88 | $239.88 |
BCBS South Carolina Setting Facility Modifier None Typical Low $165.96 Median $245.47 Typical High $426.58 | Facility | None | $165.96 | $245.47 | $426.58 |
BCBS South Carolina Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $245.47 | Professional | None | $229.09 | $229.09 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $398.11 Typical High $562.34 | Facility | None | $323.59 | $398.11 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $263.03 Typical High $616.60 | Facility | None | $239.88 | $263.03 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $257.04 | Professional | None | $169.82 | $169.82 | $257.04 |
Molina Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $549.54 | Professional | None | $537.03 | $537.03 | $549.54 |
United Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $234.42 | Professional | None | $177.83 | $223.87 | $234.42 |
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 $114.82 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $114.82 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $45.71 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $33.88 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $22.91 | $23.99 | $23.99 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $85.11 Median $85.11 Typical High $147.91 | Professional | 51 · Multiple procedures | $85.11 | $85.11 | $147.91 |
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· 32nd of 51
$229
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.