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 $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $426.58 | Professional | None | $407.38 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $204.17 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $81.28 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $42.66 |
BCBS South Carolina Setting Facility Modifier None Typical Low $295.12 Median $457.09 Typical High $812.83 | Facility | None | $295.12 | $457.09 | $812.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $407.38 Median $416.87 Typical High $446.68 | Professional | None | $407.38 | $416.87 | $446.68 |
Medcost Setting Facility Modifier None Typical Low $426.58 Median $512.86 Typical High $1,047.13 | Facility | None | $426.58 | $512.86 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $457.09 | Professional | None | $281.84 | $281.84 | $457.09 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $954.99 Typical High $1,000.00 | Professional | None | $30.20 | $954.99 | $1,000.00 |
United Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $891.25 | Facility | None | $407.38 | $407.38 | $891.25 |
United Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $416.87 | Professional | None | $316.23 | $389.05 | $416.87 |
1 more rate 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $141.25 Median $141.25 Typical High $251.19 | Professional | 51 · Multiple procedures | $141.25 | $141.25 | $251.19 |
Where South Carolina sits
The same service costs 1.5 times more in Alaska than in Oklahoma. 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· 24th of 51
$417
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.