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 $56.23 Median $85.11 Typical High $21,877.62 | Facility | None | $56.23 | $85.11 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $120.23 | Professional | None | $56.23 | $75.86 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $81.28 | Professional | None | $72.44 | $81.28 | $81.28 |
BCBS South Carolina Setting Facility Modifier None Typical Low $134.90 Median $229.09 Typical High $416.87 | Facility | None | $134.90 | $229.09 | $416.87 |
BCBS South Carolina Setting Professional Modifier None Typical Low $42.66 Median $70.79 Typical High $123.03 | Professional | None | $42.66 | $70.79 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $794.33 | Facility | None | $52.48 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $165.96 | Professional | None | $66.07 | $102.33 | $165.96 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $114.82 | Facility | None | $43.65 | $69.18 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $77.62 Median $144.54 Typical High $165.96 | Professional | None | $77.62 | $144.54 | $165.96 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $125.89 | Professional | None | $66.07 | $97.72 | $125.89 |
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 $48.98 Median $87.10 Typical High $190.55 | Professional | None | $48.98 | $87.10 | $190.55 |
7 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 $28.18 Median $30.90 Typical High $42.66 | Professional | 52 · Reduced service | $28.18 | $30.90 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.30 Typical High $16.98 | Professional | 53 · Discontinued | $11.22 | $12.30 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $46.77 Typical High $64.57 | Professional | 54 · Surgery only | $42.66 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.33 Typical High $12.88 | Professional | 55 · Aftercare only | $8.51 | $9.33 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.17 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.62 | $6.17 | $8.51 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $151.36 Median $239.88 Typical High $245.47 | Professional | 50 · Both sides | $151.36 | $239.88 | $245.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $50.12 Median $79.43 Typical High $83.18 | Professional | 51 · Multiple procedures | $50.12 | $79.43 | $83.18 |
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· 39th of 51
$85.11
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.