How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $47.86 Median $47.86 Typical High $64.57 | Facility | None | $47.86 | $47.86 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $54.95 Typical High $83.18 | Professional | None | $47.86 | $54.95 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $72.44 | Professional | None | $64.57 | $64.57 | $72.44 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $44.67 Median $75.86 Typical High $79.43 | Professional | 29 | $44.67 | $75.86 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $97.72 | Professional | None | $72.44 | $72.44 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $64.57 Median $70.79 Typical High $117.49 | Facility | None | $64.57 | $70.79 | $117.49 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $83.18 | Professional | None | $72.44 | $83.18 | $83.18 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $109.65 | Professional | None | $83.18 | $97.72 | $109.65 |
United Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $131.83 | Professional | None | $69.18 | $81.28 | $131.83 |
3 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 $31.62 Median $31.62 Typical High $40.74 | Professional | 52 · Reduced service | $31.62 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $12.02 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $8.13 |
Where South Carolina sits
The same service costs 2.1 times more in Oregon than in Alabama. 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· 42nd of 51
$72.44
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.