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 $69.18 Median $4,897.79 Typical High $21,877.62 | Facility | None | $69.18 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $112.20 Typical High $154.88 | Professional | None | $69.18 | $112.20 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $112.20 Typical High $169.82 | Professional | None | $58.88 | $112.20 | $169.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $218.78 Median $389.05 Typical High $724.44 | Facility | None | $218.78 | $389.05 | $724.44 |
BCBS South Carolina Setting Professional Modifier None Typical Low $53.70 Median $100.00 Typical High $144.54 | Professional | None | $53.70 | $100.00 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $72.44 Typical High $151.36 | Facility | None | $57.54 | $72.44 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $194.98 | Professional | None | $93.33 | $120.23 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $64.57 Median $87.10 Typical High $123.03 | Facility | None | $64.57 | $87.10 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $223.87 | Professional | None | $95.50 | $154.88 | $223.87 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $190.55 | Professional | None | $95.50 | $138.04 | $190.55 |
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 $63.10 Median $109.65 Typical High $190.55 | Professional | None | $63.10 | $109.65 | $190.55 |
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 $34.67 Median $41.69 Typical High $56.23 | Professional | 52 · Reduced service | $34.67 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $16.60 Typical High $22.39 | Professional | 53 · Discontinued | $13.80 | $16.60 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $63.10 Typical High $83.18 | Professional | 54 · Surgery only | $52.48 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.59 Typical High $16.60 | Professional | 55 · Aftercare only | $10.47 | $12.59 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.32 Typical High $11.22 | Professional | 56 · Pre-op care only | $6.92 | $8.32 | $11.22 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $61.66 Median $77.62 Typical High $112.20 | Professional | 51 · Multiple procedures | $61.66 | $77.62 | $112.20 |
Where South Carolina sits
The same service costs 3.0 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· 28th of 51
$117
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.