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 $66.07 Median $5,623.41 Typical High $21,877.62 | Facility | None | $66.07 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $114.82 Typical High $158.49 | Professional | None | $53.70 | $114.82 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $40.74 Median $87.10 Typical High $186.21 | Professional | None | $40.74 | $87.10 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $117.49 Typical High $245.47 | Professional | None | $58.88 | $117.49 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Medcost Setting Facility Modifier None Typical Low $57.54 Median $128.82 Typical High $218.78 | Facility | None | $57.54 | $128.82 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $302.00 | Professional | None | $85.11 | $154.88 | $302.00 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $190.55 | Professional | None | $100.00 | $128.82 | $190.55 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $2,951.21 | Facility | None | $446.68 | $1,621.81 | $2,951.21 |
United Setting Professional Modifier None Typical Low $50.12 Median $125.89 Typical High $295.12 | Professional | None | $50.12 | $125.89 | $295.12 |
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 $27.54 Median $57.54 Typical High $79.43 | Professional | 52 · Reduced service | $27.54 | $57.54 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $23.44 Typical High $32.36 | Professional | 53 · Discontinued | $10.96 | $23.44 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $87.10 Typical High $120.23 | Professional | 54 · Surgery only | $41.69 | $87.10 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $17.38 Typical High $23.99 | Professional | 55 · Aftercare only | $8.32 | $17.38 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $11.48 Typical High $15.85 | Professional | 56 · Pre-op care only | $5.50 | $11.48 | $15.85 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $42.66 Median $83.18 Typical High $151.36 | Professional | 51 · Multiple procedures | $42.66 | $83.18 | $151.36 |
Where South Carolina sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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· 34th of 51
$115
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.