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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | None | $60.26 | $63.10 | $63.10 |
BCBS South Carolina Setting Facility Modifier None Typical Low $74.13 Median $102.33 Typical High $162.18 | Facility | None | $74.13 | $102.33 | $162.18 |
BCBS South Carolina Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $95.50 | Professional | None | $60.26 | $77.62 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $104.71 Typical High $147.91 | Facility | None | $85.11 | $104.71 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Medcost Setting Facility Modifier None Typical Low $63.10 Median $75.86 Typical High $109.65 | Facility | None | $63.10 | $75.86 | $109.65 |
Medcost Setting Professional Modifier None Typical Low $39.81 Median $91.20 Typical High $109.65 | Professional | None | $39.81 | $91.20 | $109.65 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $125.89 Typical High $147.91 | Professional | None | $30.20 | $125.89 | $147.91 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $128.82 | Facility | None | $60.26 | $60.26 | $128.82 |
United Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $60.26 | Professional | None | $44.67 | $56.23 | $60.26 |
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 $30.20 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $30.20 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $12.02 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $9.12 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $6.03 | $6.31 | $6.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $25.12 Median $45.71 Typical High $45.71 | Professional | 51 · Multiple procedures | $25.12 | $45.71 | $45.71 |
Where South Carolina sits
The same service costs 2.0 times more in Wyoming than in Hawaii. 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· 5th of 51
$63.10
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.