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 $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $28.84 | Professional | None | $4.79 | $4.79 | $28.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.40 Median $2.40 Typical High $14.45 | Professional | 52 · Reduced service | $2.40 | $2.40 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $0.95 Typical High $5.75 | Professional | 53 · Discontinued | $0.95 | $0.95 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $0.72 Typical High $4.37 | Professional | 55 · Aftercare only | $0.72 | $0.72 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.48 Median $0.48 Typical High $2.88 | Professional | 56 · Pre-op care only | $0.48 | $0.48 | $2.88 |
BCBS South Carolina Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $89.13 | Facility | None | $38.02 | $38.02 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $23.99 | Professional | None | $19.05 | $19.05 | $23.99 |
Medcost Setting Facility Modifier None Typical Low $4.79 Median $5.75 Typical High $6.46 | Facility | None | $4.79 | $5.75 | $6.46 |
Medcost Setting Professional Modifier None Typical Low $3.55 Median $5.01 Typical High $6.03 | Professional | None | $3.55 | $5.01 | $6.03 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $44.67 | Professional | None | $30.20 | $30.20 | $44.67 |
United Setting Facility Modifier None Typical Low $158.49 Median $190.55 Typical High $251.19 | Facility | None | $158.49 | $190.55 | $251.19 |
United Setting Professional Modifier None Typical Low $19.95 Median $23.99 Typical High $23.99 | Professional | None | $19.95 | $23.99 | $23.99 |
2 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 |
|---|---|---|---|---|---|
BCBS South Carolina Setting Professional Modifier 29 Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 29 | $30.90 | $30.90 | $30.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.78 Median $2.51 Typical High $3.80 | Professional | 51 · Multiple procedures | $1.78 | $2.51 | $3.80 |
Where South Carolina sits
The same service costs 11.7 times more in New York than in North Carolina. 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· 38th of 51
$23.99
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.