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 $93.33 Median $123.03 Typical High $199.53 | Professional | None | $93.33 | $123.03 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
BCBS South Carolina Setting Facility Modifier None Typical Low $457.09 Median $776.25 Typical High $1,513.56 | Facility | None | $457.09 | $776.25 | $1,513.56 |
BCBS South Carolina Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $147.91 | Professional | None | $77.62 | $114.82 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $229.09 Typical High $707.95 | Facility | None | $85.11 | $229.09 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $229.09 | Professional | None | $97.72 | $125.89 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $93.33 Typical High $158.49 | Facility | None | $70.79 | $93.33 | $158.49 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $177.83 | Professional | None | $123.03 | $151.36 | $177.83 |
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 $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 $89.13 Median $128.82 Typical High $218.78 | Professional | None | $89.13 | $128.82 | $218.78 |
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 $47.86 Median $52.48 Typical High $72.44 | Professional | 52 · Reduced service | $47.86 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $21.38 Typical High $28.84 | Professional | 53 · Discontinued | $19.05 | $21.38 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $79.43 Typical High $109.65 | Professional | 54 · Surgery only | $74.13 | $79.43 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.85 Typical High $21.88 | Professional | 55 · Aftercare only | $14.45 | $15.85 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.47 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.55 | $10.47 | $14.45 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $70.79 Median $81.28 Typical High $107.15 | Professional | 51 · Multiple procedures | $70.79 | $81.28 | $107.15 |
Where South Carolina sits
The same service costs 3.3 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· 30th of 51
$145
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.