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 $72.44 Median $4,897.79 Typical High $21,877.62 | Facility | None | $72.44 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $112.20 | Professional | None | $64.57 | $87.10 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
BCBS South Carolina Setting Facility Modifier None Typical Low $977.24 Median $1,584.89 Typical High $2,951.21 | Facility | None | $977.24 | $1,584.89 | $2,951.21 |
BCBS South Carolina Setting Professional Modifier None Typical Low $56.23 Median $95.50 Typical High $128.82 | Professional | None | $56.23 | $95.50 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $147.91 Typical High $707.95 | Facility | None | $66.07 | $147.91 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $177.83 | Professional | None | $70.79 | $97.72 | $177.83 |
Medcost Setting Facility Modifier None Typical Low $53.70 Median $72.44 Typical High $125.89 | Facility | None | $53.70 | $72.44 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $138.04 | Professional | None | $95.50 | $117.49 | $138.04 |
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 $302.00 Median $1,122.02 Typical High $6,165.95 | Facility | None | $302.00 | $1,122.02 | $6,165.95 |
United Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $162.18 | Professional | None | $64.57 | $100.00 | $162.18 |
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 $35.48 Median $39.81 Typical High $56.23 | Professional | 52 · Reduced service | $35.48 | $39.81 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $15.85 Typical High $22.39 | Professional | 53 · Discontinued | $14.13 | $15.85 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $58.88 Typical High $85.11 | Professional | 54 · Surgery only | $53.70 | $58.88 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.02 Typical High $16.98 | Professional | 55 · Aftercare only | $10.72 | $12.02 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.94 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.08 | $7.94 | $11.22 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $61.66 Typical High $81.28 | Professional | 51 · Multiple procedures | $48.98 | $61.66 | $81.28 |
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· 31st of 51
$107
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.