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 $37.15 Median $4,897.79 Typical High $21,877.62 | Facility | None | $37.15 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $74.13 Typical High $117.49 | Professional | None | $37.15 | $74.13 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $14.13 Median $58.88 Typical High $81.28 | Professional | None | $14.13 | $58.88 | $81.28 |
BCBS South Carolina Setting Facility Modifier None Typical Low $269.15 Median $489.78 Typical High $891.25 | Facility | None | $269.15 | $489.78 | $891.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $25.12 Median $57.54 Typical High $107.15 | Professional | None | $25.12 | $57.54 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $75.86 Typical High $151.36 | Facility | None | $61.66 | $75.86 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $81.28 Typical High $147.91 | Professional | None | $47.86 | $81.28 | $147.91 |
Medcost Setting Facility Modifier None Typical Low $42.66 Median $85.11 Typical High $100.00 | Facility | None | $42.66 | $85.11 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $120.23 | Professional | None | $72.44 | $112.20 | $120.23 |
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 $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $30.90 Median $72.44 Typical High $151.36 | Professional | None | $30.90 | $72.44 | $151.36 |
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 $18.62 Median $23.44 Typical High $45.71 | Professional | 52 · Reduced service | $18.62 | $23.44 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $9.33 Typical High $18.20 | Professional | 53 · Discontinued | $7.41 | $9.33 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $35.48 Typical High $69.18 | Professional | 54 · Surgery only | $27.54 | $35.48 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $7.08 Typical High $13.80 | Professional | 55 · Aftercare only | $5.50 | $7.08 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.68 Typical High $9.12 | Professional | 56 · Pre-op care only | $3.72 | $4.68 | $9.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $43.65 Median $56.23 Typical High $67.61 | Professional | 51 · Multiple procedures | $43.65 | $56.23 | $67.61 |
Where South Carolina sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 14th of 51
$95.50
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.