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 $199.53 Median $5,623.41 Typical High $21,877.62 | Facility | None | $199.53 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $354.81 Typical High $457.09 | Professional | None | $199.53 | $354.81 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
BCBS South Carolina Setting Facility Modifier None Typical Low $660.69 Median $1,071.52 Typical High $2,884.03 | Facility | None | $660.69 | $1,071.52 | $2,884.03 |
BCBS South Carolina Setting Professional Modifier None Typical Low $141.25 Median $257.04 Typical High $371.54 | Professional | None | $141.25 | $257.04 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $575.44 Typical High $977.24 | Facility | None | $346.74 | $575.44 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $416.87 Typical High $645.65 | Professional | None | $190.55 | $416.87 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $512.86 Typical High $851.14 | Facility | None | $199.53 | $512.86 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $501.19 Typical High $645.65 | Professional | None | $208.93 | $501.19 | $645.65 |
Molina Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $691.83 | Professional | None | $354.81 | $501.19 | $691.83 |
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 $162.18 Median $363.08 Typical High $794.33 | Professional | None | $162.18 | $363.08 | $794.33 |
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 $100.00 Median $109.65 Typical High $229.09 | Professional | 52 · Reduced service | $100.00 | $109.65 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $43.65 Typical High $91.20 | Professional | 53 · Discontinued | $39.81 | $43.65 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $165.96 Typical High $346.74 | Professional | 54 · Surgery only | $151.36 | $165.96 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $33.11 Typical High $69.18 | Professional | 55 · Aftercare only | $30.20 | $33.11 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.88 Typical High $45.71 | Professional | 56 · Pre-op care only | $19.95 | $21.88 | $45.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $104.71 Median $257.04 Typical High $338.84 | Professional | 51 · Multiple procedures | $104.71 | $257.04 | $338.84 |
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· 21st of 51
$427
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.