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 $63.10 Median $4,365.16 Typical High $16,595.87 | Facility | None | $63.10 | $4,365.16 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $154.88 | Professional | None | $63.10 | $100.00 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $114.82 Typical High $147.91 | Professional | None | $69.18 | $114.82 | $147.91 |
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 $45.71 Median $83.18 Typical High $141.25 | Professional | None | $45.71 | $83.18 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $169.82 Typical High $707.95 | Facility | None | $75.86 | $169.82 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $107.15 Typical High $165.96 | Professional | None | $67.61 | $107.15 | $165.96 |
Medcost Setting Facility Modifier None Typical Low $63.10 Median $97.72 Typical High $134.90 | Facility | None | $63.10 | $97.72 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $144.54 Typical High $158.49 | Professional | None | $93.33 | $144.54 | $158.49 |
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 $51.29 Median $95.50 Typical High $199.53 | Professional | None | $51.29 | $95.50 | $199.53 |
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 $31.62 Median $37.15 Typical High $58.88 | Professional | 52 · Reduced service | $31.62 | $37.15 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $14.79 Typical High $23.44 | Professional | 53 · Discontinued | $12.59 | $14.79 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $54.95 Typical High $87.10 | Professional | 54 · Surgery only | $46.77 | $54.95 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.96 Typical High $17.38 | Professional | 55 · Aftercare only | $9.33 | $10.96 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.41 Typical High $11.75 | Professional | 56 · Pre-op care only | $6.31 | $7.41 | $11.75 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $53.70 Median $72.44 Typical High $85.11 | Professional | 51 · Multiple procedures | $53.70 | $72.44 | $85.11 |
Where South Carolina sits
The same service costs 2.8 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· 20th of 51
$117
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.