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 $79.43 Median $91.20 Typical High $107.15 | Facility | None | $79.43 | $91.20 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $91.20 Typical High $123.03 | Professional | None | $79.43 | $91.20 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $128.82 | Professional | None | $102.33 | $128.82 | $128.82 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $63.10 Median $120.23 Typical High $128.82 | Professional | 29 | $63.10 | $120.23 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $162.18 | Professional | None | $107.15 | $107.15 | $162.18 |
Medcost Setting Facility Modifier None Typical Low $107.15 Median $112.20 Typical High $181.97 | Facility | None | $107.15 | $112.20 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $128.82 | Professional | None | $120.23 | $128.82 | $128.82 |
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 $102.33 Median $125.89 Typical High $204.17 | Professional | None | $102.33 | $125.89 | $204.17 |
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 $53.70 Median $53.70 Typical High $61.66 | Professional | 52 · Reduced service | $53.70 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $18.62 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $12.30 |
Where South Carolina sits
The same service costs 2.1 times more in Wisconsin than in Ohio. 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· 46th of 51
$107
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.