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 $134.90 Median $4,897.79 Typical High $21,877.62 | Facility | None | $134.90 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $269.15 | Professional | None | $134.90 | $169.82 | $269.15 |
BCBS South Carolina Setting Facility Modifier None Typical Low $467.74 Median $794.33 Typical High $1,513.56 | Facility | None | $467.74 | $794.33 | $1,513.56 |
BCBS South Carolina Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $204.17 | Professional | None | $104.71 | $158.49 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $295.12 Typical High $707.95 | Facility | None | $109.65 | $295.12 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $309.03 | Professional | None | $134.90 | $169.82 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $123.03 Typical High $213.80 | Facility | None | $91.20 | $123.03 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $234.42 | Professional | None | $165.96 | $204.17 | $234.42 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $316.23 | Professional | None | $162.18 | $223.87 | $316.23 |
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 $120.23 Median $173.78 Typical High $295.12 | Professional | None | $120.23 | $173.78 | $295.12 |
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 $64.57 Median $70.79 Typical High $97.72 | Professional | 52 · Reduced service | $64.57 | $70.79 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $28.84 Typical High $38.90 | Professional | 53 · Discontinued | $26.30 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $107.15 Typical High $144.54 | Professional | 54 · Surgery only | $97.72 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $21.38 Typical High $29.51 | Professional | 55 · Aftercare only | $19.50 | $21.38 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.13 Typical High $19.50 | Professional | 56 · Pre-op care only | $13.18 | $14.13 | $19.50 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $109.65 Typical High $158.49 | Professional | 51 · Multiple procedures | $95.50 | $109.65 | $158.49 |
Where South Carolina sits
The same service costs 3.7 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
$195
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.