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 $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $16.60 Typical High $16.60 | Professional | None | $13.18 | $16.60 | $16.60 |
BCBS South Carolina Setting Facility Modifier None Typical Low $19.05 Median $20.89 Typical High $20.89 | Facility | None | $19.05 | $20.89 | $20.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $12.88 Median $14.13 Typical High $20.89 | Professional | None | $12.88 | $14.13 | $20.89 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $12.30 Typical High $12.30 | Facility | None | $8.91 | $12.30 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $12.30 | Professional | None | $10.47 | $10.47 | $12.30 |
Medcost Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $13.49 | Professional | None | $10.47 | $10.47 | $13.49 |
Medcost Setting Facility Modifier None Typical Low $5.62 Median $17.38 Typical High $25.70 | Facility | None | $5.62 | $17.38 | $25.70 |
Medcost Setting Professional Modifier None Typical Low $12.88 Median $15.85 Typical High $27.54 | Professional | None | $12.88 | $15.85 | $27.54 |
Molina Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
United Setting Professional Modifier None Typical Low $6.92 Median $9.77 Typical High $12.59 | Professional | None | $6.92 | $9.77 | $12.59 |
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 55 · Aftercare only Typical Low $2.14 Median $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $2.14 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.66 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.45 | $1.66 | $1.66 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.46 Median $7.94 Typical High $18.20 | Professional | 51 · Multiple procedures | $6.46 | $7.94 | $18.20 |
Where South Carolina sits
The same service costs 3.0 times more in Hawaii than in Rhode Island. 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· 20th of 51
$14.13
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.