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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,258.93 | $1,318.26 | $1,318.26 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $3,235.94 | Facility | None | $1,202.26 | $1,737.80 | $3,235.94 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,479.11 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $3,090.30 | Facility | None | $1,778.28 | $2,187.76 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $741.31 | Professional | None | $691.83 | $691.83 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $4,168.69 | Facility | None | $1,258.93 | $1,698.24 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $977.24 Typical High $1,698.24 | Professional | None | $575.44 | $977.24 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $3,090.30 Typical High $3,235.94 | Professional | None | $30.20 | $3,090.30 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,691.53 | Facility | None | $1,258.93 | $1,258.93 | $2,691.53 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,348.96 | Professional | None | $1,023.29 | $1,288.25 | $1,348.96 |
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 $630.96 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $630.96 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $251.19 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $190.55 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $125.89 | $131.83 | $131.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $288.40 Median $489.78 Typical High $1,071.52 | Professional | 51 · Multiple procedures | $288.40 | $489.78 | $1,071.52 |
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· 18th of 51
$1,318
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.