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 $97.72 Median $4,897.79 Typical High $21,877.62 | Facility | None | $97.72 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $165.96 | Professional | None | $97.72 | $131.83 | $165.96 |
BCBS South Carolina Setting Facility Modifier None Typical Low $489.78 Median $831.76 Typical High $5,370.32 | Facility | None | $489.78 | $831.76 | $5,370.32 |
BCBS South Carolina Setting Professional Modifier None Typical Low $70.79 Median $125.89 Typical High $162.18 | Professional | None | $70.79 | $125.89 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $457.09 Typical High $776.25 | Facility | None | $346.74 | $457.09 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $257.04 | Professional | None | $104.71 | $165.96 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $97.72 Median $269.15 Typical High $630.96 | Facility | None | $97.72 | $269.15 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $239.88 | Professional | None | $154.88 | $213.80 | $239.88 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $251.19 | Professional | None | $128.82 | $181.97 | $251.19 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,025.60 | Facility | None | $302.00 | $1,122.02 | $6,025.60 |
United Setting Professional Modifier None Typical Low $77.62 Median $138.04 Typical High $288.40 | Professional | None | $77.62 | $138.04 | $288.40 |
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 $48.98 Median $52.48 Typical High $83.18 | Professional | 52 · Reduced service | $48.98 | $52.48 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $20.89 Typical High $33.11 | Professional | 53 · Discontinued | $19.50 | $20.89 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $79.43 Typical High $123.03 | Professional | 54 · Surgery only | $72.44 | $79.43 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.85 Typical High $24.55 | Professional | 55 · Aftercare only | $14.45 | $15.85 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.47 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.77 | $10.47 | $16.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $107.15 Typical High $128.82 | Professional | 51 · Multiple procedures | $95.50 | $107.15 | $128.82 |
Where South Carolina sits
The same service costs 3.6 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· 27th of 51
$166
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.