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 $16.22 Median $5,623.41 Typical High $21,877.62 | Facility | None | $16.22 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $16.22 Typical High $32.36 | Professional | None | $14.45 | $16.22 | $32.36 |
Ambetter Setting Professional Modifier None Typical Low $13.49 Median $24.55 Typical High $28.84 | Professional | None | $13.49 | $24.55 | $28.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $58.88 Median $79.43 Typical High $190.55 | Facility | None | $58.88 | $79.43 | $190.55 |
BCBS South Carolina Setting Professional Modifier None Typical Low $10.23 Median $15.85 Typical High $19.50 | Professional | None | $10.23 | $15.85 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $151.36 Typical High $851.14 | Facility | None | $58.88 | $151.36 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $15.14 Typical High $30.20 | Professional | None | $14.45 | $15.14 | $30.20 |
Medcost Setting Facility Modifier None Typical Low $15.49 Median $16.22 Typical High $41.69 | Facility | None | $15.49 | $16.22 | $41.69 |
Medcost Setting Professional Modifier None Typical Low $13.80 Median $16.22 Typical High $19.95 | Professional | None | $13.80 | $16.22 | $19.95 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $47.86 Typical High $63.10 | Professional | None | $32.36 | $47.86 | $63.10 |
United Setting Facility Modifier None Typical Low $83.18 Median $380.19 Typical High $2,238.72 | Facility | None | $83.18 | $380.19 | $2,238.72 |
United Setting Professional Modifier None Typical Low $12.02 Median $16.22 Typical High $26.92 | Professional | None | $12.02 | $16.22 | $26.92 |
8 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 $7.24 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $7.24 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $3.24 Typical High $3.24 | Professional | 53 · Discontinued | $2.88 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.72 Median $12.30 Typical High $12.30 | Professional | 54 · Surgery only | $10.72 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $2.14 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.45 | $1.62 | $1.62 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $19.05 Median $33.11 Typical High $37.15 | Professional | 50 · Both sides | $19.05 | $33.11 | $37.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $24.55 Median $24.55 Typical High $38.90 | Professional | 50 · Both sides | $24.55 | $24.55 | $38.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $8.13 Median $8.13 Typical High $13.18 | Professional | 51 · Multiple procedures | $8.13 | $8.13 | $13.18 |
Where South Carolina sits
The same service costs 7.4 times more in Kansas 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· 23rd of 51
$23.44
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.