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 $70.79 Median $131.83 Typical High $21,877.62 | Facility | None | $70.79 | $131.83 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $131.83 | Professional | None | $66.07 | $102.33 | $131.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $2,041.74 Typical High $3,548.13 | Facility | None | $1,174.90 | $2,041.74 | $3,548.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $109.65 | Professional | None | $51.29 | $64.57 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $204.17 Typical High $707.95 | Facility | None | $93.33 | $204.17 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $112.20 Typical High $204.17 | Professional | None | $64.57 | $112.20 | $204.17 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $131.83 Typical High $162.18 | Facility | None | $70.79 | $131.83 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $151.36 | Professional | None | $102.33 | $131.83 | $151.36 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $190.55 | Professional | None | $95.50 | $138.04 | $190.55 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $56.23 Median $104.71 Typical High $177.83 | Professional | None | $56.23 | $104.71 | $177.83 |
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 $34.67 Median $36.31 Typical High $66.07 | Professional | 52 · Reduced service | $34.67 | $36.31 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.45 Typical High $26.30 | Professional | 53 · Discontinued | $13.80 | $14.45 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $53.70 Typical High $100.00 | Professional | 54 · Surgery only | $52.48 | $53.70 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.72 Typical High $19.95 | Professional | 55 · Aftercare only | $10.47 | $10.72 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.24 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.92 | $7.24 | $13.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $51.29 Median $70.79 Typical High $97.72 | Professional | 51 · Multiple procedures | $51.29 | $70.79 | $97.72 |
Where South Carolina sits
The same service costs 3.9 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· 28th of 51
$112
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.