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 $245.47 Median $5,623.41 Typical High $21,877.62 | Facility | None | $245.47 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $776.25 Typical High $977.24 | Professional | None | $245.47 | $776.25 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,388.44 Median $4,570.88 Typical High $10,715.19 | Facility | None | $3,388.44 | $4,570.88 | $10,715.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $177.83 Median $416.87 Typical High $794.33 | Professional | None | $177.83 | $416.87 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $588.84 Typical High $1,348.96 | Professional | None | $275.42 | $588.84 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $245.47 Median $562.34 Typical High $1,318.26 | Facility | None | $245.47 | $562.34 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,318.26 | Professional | None | $954.99 | $1,071.52 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,513.56 | Professional | None | $794.33 | $1,047.13 | $1,513.56 |
United Setting Facility Modifier None Typical Low $7,585.78 Median $15,135.61 Typical High $23,442.29 | Facility | None | $7,585.78 | $15,135.61 | $23,442.29 |
United Setting Professional Modifier None Typical Low $213.80 Median $676.08 Typical High $1,548.82 | Professional | None | $213.80 | $676.08 | $1,548.82 |
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 $120.23 Median $346.74 Typical High $489.78 | Professional | 52 · Reduced service | $120.23 | $346.74 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $138.04 Typical High $194.98 | Professional | 53 · Discontinued | $48.98 | $138.04 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $512.86 Typical High $741.31 | Professional | 54 · Surgery only | $181.97 | $512.86 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $104.71 Typical High $147.91 | Professional | 55 · Aftercare only | $36.31 | $104.71 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $69.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $24.55 | $69.18 | $97.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $537.03 Typical High $1,202.26 | Professional | 51 · Multiple procedures | $537.03 | $537.03 | $1,202.26 |
Where South Carolina sits
The same service costs 5.4 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· 26th of 51
$794
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.