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 $112.20 Median $4,897.79 Typical High $21,877.62 | Facility | None | $112.20 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $223.87 | Professional | None | $112.20 | $147.91 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $263.03 | Professional | None | $95.50 | $134.90 | $263.03 |
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 $87.10 Median $144.54 Typical High $218.78 | Professional | None | $87.10 | $144.54 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $239.88 Typical High $707.95 | Facility | None | $89.13 | $239.88 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $263.03 | Professional | None | $112.20 | $147.91 | $263.03 |
Medcost Setting Facility Modifier None Typical Low $81.28 Median $109.65 Typical High $181.97 | Facility | None | $81.28 | $109.65 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $204.17 | Professional | None | $141.25 | $177.83 | $204.17 |
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 $100.00 Median $151.36 Typical High $251.19 | Professional | None | $100.00 | $151.36 | $251.19 |
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 $54.95 Median $61.66 Typical High $83.18 | Professional | 52 · Reduced service | $54.95 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $24.55 Typical High $33.11 | Professional | 53 · Discontinued | $21.88 | $24.55 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $91.20 Typical High $125.89 | Professional | 54 · Surgery only | $81.28 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $18.20 Typical High $25.12 | Professional | 55 · Aftercare only | $16.22 | $18.20 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.30 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.96 | $12.30 | $16.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $95.50 Typical High $134.90 | Professional | 51 · Multiple procedures | $83.18 | $95.50 | $134.90 |
Where South Carolina sits
The same service costs 3.2 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· 29th of 51
$162
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.