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 $45.71 Median $45.71 Typical High $56.23 | Facility | None | $45.71 | $45.71 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $54.95 Typical High $56.23 | Professional | None | $45.71 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $26.92 Typical High $28.18 | Professional | 52 · Reduced service | $22.91 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $8.13 Typical High $8.51 | Professional | 55 · Aftercare only | $6.76 | $8.13 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.50 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.57 | $5.50 | $5.62 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $151.36 | Professional | None | $107.15 | $107.15 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $58.88 Typical High $95.50 | Professional | None | $48.98 | $58.88 | $95.50 |
Medcost Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $147.91 | Facility | None | $50.12 | $61.66 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $35.48 Median $72.44 Typical High $100.00 | Professional | None | $35.48 | $72.44 | $100.00 |
United Setting Professional Modifier None Typical Low $52.48 Median $66.07 Typical High $102.33 | Professional | None | $52.48 | $66.07 | $102.33 |
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 $95.50 Median $97.72 Typical High $144.54 | Professional | 29 | $95.50 | $97.72 | $144.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $17.78 Median $36.31 Typical High $54.95 | Professional | 51 · Multiple procedures | $17.78 | $36.31 | $54.95 |
Where South Carolina sits
The same service costs 2.6 times more in Alaska 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· 35th of 51
$56.23
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.