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 $77.62 Median $4,897.79 Typical High $21,877.62 | Facility | None | $77.62 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $107.15 | Professional | None | $72.44 | $87.10 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
BCBS South Carolina Setting Facility Modifier None Typical Low $457.09 Median $776.25 Typical High $1,380.38 | Facility | None | $457.09 | $776.25 | $1,380.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $54.95 Median $81.28 Typical High $117.49 | Professional | None | $54.95 | $81.28 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $117.49 Typical High $707.95 | Facility | None | $52.48 | $117.49 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $169.82 | Professional | None | $74.13 | $102.33 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $46.77 Median $63.10 Typical High $120.23 | Facility | None | $46.77 | $63.10 | $120.23 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $125.89 | Professional | None | $83.18 | $112.20 | $125.89 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $125.89 | Professional | None | $64.57 | $89.13 | $125.89 |
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 $63.10 Median $95.50 Typical High $158.49 | Professional | None | $63.10 | $95.50 | $158.49 |
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 $38.90 Median $40.74 Typical High $53.70 | Professional | 52 · Reduced service | $38.90 | $40.74 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $16.22 Typical High $21.38 | Professional | 53 · Discontinued | $15.49 | $16.22 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $61.66 Typical High $81.28 | Professional | 54 · Surgery only | $57.54 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.30 Typical High $16.22 | Professional | 55 · Aftercare only | $11.75 | $12.30 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.13 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.76 | $8.13 | $10.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $43.65 Median $57.54 Typical High $79.43 | Professional | 51 · Multiple procedures | $43.65 | $57.54 | $79.43 |
Where South Carolina sits
The same service costs 3.5 times more in Wisconsin than in Florida. 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· 35th of 51
$97.72
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.