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 $19.95 Median $26.30 Typical High $41.69 | Facility | None | $19.95 | $26.30 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $28.18 Typical High $38.02 | Professional | None | $17.78 | $28.18 | $38.02 |
Ambetter Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
BCBS South Carolina Setting Facility Modifier None Typical Low $26.30 Median $54.95 Typical High $102.33 | Facility | None | $26.30 | $54.95 | $102.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $12.88 Median $26.30 Typical High $38.02 | Professional | None | $12.88 | $26.30 | $38.02 |
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 $16.98 Median $34.67 Typical High $53.70 | Professional | None | $16.98 | $34.67 | $53.70 |
Medcost Setting Facility Modifier None Typical Low $10.72 Median $22.91 Typical High $41.69 | Facility | None | $10.72 | $22.91 | $41.69 |
Medcost Setting Professional Modifier None Typical Low $36.31 Median $42.66 Typical High $48.98 | Professional | None | $36.31 | $42.66 | $48.98 |
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 $15.85 Median $29.51 Typical High $53.70 | Professional | None | $15.85 | $29.51 | $53.70 |
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 $9.12 Median $12.02 Typical High $19.05 | Professional | 52 · Reduced service | $9.12 | $12.02 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $4.79 Typical High $7.59 | Professional | 53 · Discontinued | $3.63 | $4.79 | $7.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.80 Median $18.20 Typical High $28.18 | Professional | 54 · Surgery only | $13.80 | $18.20 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.63 Typical High $5.62 | Professional | 55 · Aftercare only | $2.75 | $3.63 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $2.40 Typical High $3.80 | Professional | 56 · Pre-op care only | $1.82 | $2.40 | $3.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.50 Median $22.91 Typical High $29.51 | Professional | 51 · Multiple procedures | $19.50 | $22.91 | $29.51 |
Where South Carolina sits
The same service costs 3.5 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· 33rd of 51
$33.11
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.