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 $51.29 Median $81.28 Typical High $21,877.62 | Facility | None | $51.29 | $81.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $100.00 | Professional | None | $48.98 | $70.79 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $123.03 | Professional | None | $79.43 | $104.71 | $123.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $223.87 Median $389.05 Typical High $676.08 | Facility | None | $223.87 | $389.05 | $676.08 |
BCBS South Carolina Setting Professional Modifier None Typical Low $38.90 Median $61.66 Typical High $95.50 | Professional | None | $38.90 | $61.66 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $56.23 Typical High $131.83 | Facility | None | $40.74 | $56.23 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $83.18 Typical High $128.82 | Professional | None | $52.48 | $83.18 | $128.82 |
Medcost Setting Facility Modifier None Typical Low $47.86 Median $74.13 Typical High $89.13 | Facility | None | $47.86 | $74.13 | $89.13 |
Medcost Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $109.65 | Professional | None | $69.18 | $95.50 | $109.65 |
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 $45.71 Median $72.44 Typical High $128.82 | Professional | None | $45.71 | $72.44 | $128.82 |
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 $25.12 Median $28.84 Typical High $40.74 | Professional | 52 · Reduced service | $25.12 | $28.84 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $11.48 Typical High $16.22 | Professional | 53 · Discontinued | $10.00 | $11.48 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $42.66 Typical High $61.66 | Professional | 54 · Surgery only | $38.02 | $42.66 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.51 Typical High $12.30 | Professional | 55 · Aftercare only | $7.59 | $8.51 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.75 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.01 | $5.75 | $8.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $43.65 Median $53.70 Typical High $66.07 | Professional | 51 · Multiple procedures | $43.65 | $53.70 | $66.07 |
Where South Carolina sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 29th of 51
$81.28
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.