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 $24.55 Median $4,897.79 Typical High $21,877.62 | Facility | None | $24.55 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $33.88 Typical High $89.13 | Professional | None | $24.55 | $33.88 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
BCBS South Carolina Setting Facility Modifier None Typical Low $134.90 Median $223.87 Typical High $398.11 | Facility | None | $134.90 | $223.87 | $398.11 |
BCBS South Carolina Setting Professional Modifier None Typical Low $19.50 Median $33.11 Typical High $75.86 | Professional | None | $19.50 | $33.11 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $794.33 | Facility | None | $52.48 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $50.12 Typical High $81.28 | Professional | None | $26.30 | $50.12 | $81.28 |
Medcost Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Medcost Setting Facility Modifier None Typical Low $25.70 Median $66.07 Typical High $89.13 | Facility | None | $25.70 | $66.07 | $89.13 |
Medcost Setting Professional Modifier None Typical Low $32.36 Median $72.44 Typical High $93.33 | Professional | None | $32.36 | $72.44 | $93.33 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $112.20 | Professional | None | $60.26 | $75.86 | $112.20 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $20.42 Median $50.12 Typical High $91.20 | Professional | None | $20.42 | $50.12 | $91.20 |
6 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 $12.30 Median $12.88 Typical High $43.65 | Professional | 52 · Reduced service | $12.30 | $12.88 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.13 Typical High $17.78 | Professional | 53 · Discontinued | $4.90 | $5.13 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $19.05 Typical High $66.07 | Professional | 54 · Surgery only | $18.20 | $19.05 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.80 Typical High $13.18 | Professional | 55 · Aftercare only | $3.63 | $3.80 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.57 Typical High $8.91 | Professional | 56 · Pre-op care only | $2.45 | $2.57 | $8.91 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.85 Median $36.31 Typical High $57.54 | Professional | 51 · Multiple procedures | $15.85 | $36.31 | $57.54 |
Where South Carolina sits
The same service costs 3.4 times more in Wisconsin than in Kentucky. 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· 48th of 51
$50.12
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.