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 $81.28 Median $4,897.79 Typical High $21,877.62 | Facility | None | $81.28 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $147.91 Typical High $194.98 | Professional | None | $81.28 | $147.91 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $131.83 Typical High $154.88 | Professional | None | $72.44 | $131.83 | $154.88 |
BCBS South Carolina Setting Facility Modifier None Typical Low $933.25 Median $1,584.89 Typical High $2,951.21 | Facility | None | $933.25 | $1,584.89 | $2,951.21 |
BCBS South Carolina Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $158.49 | Professional | None | $66.07 | $93.33 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $263.03 Typical High $707.95 | Facility | None | $120.23 | $263.03 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $147.91 Typical High $239.88 | Professional | None | $79.43 | $147.91 | $239.88 |
Medcost Setting Facility Modifier None Typical Low $81.28 Median $144.54 Typical High $194.98 | Facility | None | $81.28 | $144.54 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $204.17 | Professional | None | $131.83 | $169.82 | $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 $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 $72.44 Median $131.83 Typical High $234.42 | Professional | None | $72.44 | $131.83 | $234.42 |
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 $39.81 Median $48.98 Typical High $83.18 | Professional | 52 · Reduced service | $39.81 | $48.98 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $19.50 Typical High $33.88 | Professional | 53 · Discontinued | $15.85 | $19.50 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $74.13 Typical High $125.89 | Professional | 54 · Surgery only | $60.26 | $74.13 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.79 Typical High $25.12 | Professional | 55 · Aftercare only | $12.02 | $14.79 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.77 Typical High $16.60 | Professional | 56 · Pre-op care only | $7.94 | $9.77 | $16.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $66.07 Median $91.20 Typical High $114.82 | Professional | 51 · Multiple procedures | $66.07 | $91.20 | $114.82 |
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· 29th of 51
$151
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.