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 $436.52 Median $5,623.41 Typical High $21,877.62 | Facility | None | $436.52 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $1,445.44 Typical High $2,089.30 | Professional | None | $316.23 | $1,445.44 | $2,089.30 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $309.03 | Professional | None | $141.25 | $141.25 | $309.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,388.44 Median $6,309.57 Typical High $12,589.25 | Facility | None | $3,388.44 | $6,309.57 | $12,589.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $281.84 Median $512.86 Typical High $2,187.76 | Professional | None | $281.84 | $512.86 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $812.83 Typical High $2,454.71 | Professional | None | $389.05 | $812.83 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $354.81 Median $870.96 Typical High $2,818.38 | Facility | None | $354.81 | $870.96 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $2,754.23 | Professional | None | $1,737.80 | $1,995.26 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $3,388.44 | Professional | None | $1,778.28 | $2,398.83 | $3,388.44 |
United Setting Facility Modifier None Typical Low $7,585.78 Median $14,125.38 Typical High $22,908.68 | Facility | None | $7,585.78 | $14,125.38 | $22,908.68 |
United Setting Professional Modifier None Typical Low $316.23 Median $1,348.96 Typical High $3,019.95 | Professional | None | $316.23 | $1,348.96 | $3,019.95 |
7 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 $181.97 Median $660.69 Typical High $1,047.13 | Professional | 52 · Reduced service | $181.97 | $660.69 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $263.03 Typical High $416.87 | Professional | 53 · Discontinued | $72.44 | $263.03 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $977.24 Typical High $1,584.89 | Professional | 54 · Surgery only | $269.15 | $977.24 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $194.98 Typical High $316.23 | Professional | 55 · Aftercare only | $53.70 | $194.98 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $131.83 Typical High $208.93 | Professional | 56 · Pre-op care only | $36.31 | $131.83 | $208.93 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,019.95 Median $3,019.95 Typical High $6,918.31 | Professional | 50 · Both sides | $3,019.95 | $3,019.95 | $6,918.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,000.00 Median $1,000.00 Typical High $2,290.87 | Professional | 51 · Multiple procedures | $1,000.00 | $1,000.00 | $2,290.87 |
Where South Carolina sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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· 11th of 51
$1,738
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.