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 $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $15.85 Typical High $15.85 | Professional | None | $12.59 | $15.85 | $15.85 |
BCBS South Carolina Setting Facility Modifier None Typical Low $18.20 Median $20.42 Typical High $20.42 | Facility | None | $18.20 | $20.42 | $20.42 |
BCBS South Carolina Setting Professional Modifier None Typical Low $12.59 Median $12.88 Typical High $20.42 | Professional | None | $12.59 | $12.88 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $13.49 Typical High $13.49 | Facility | None | $9.55 | $13.49 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $13.49 | Professional | None | $11.48 | $11.48 | $13.49 |
Medcost Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $14.45 | Professional | None | $11.22 | $11.22 | $14.45 |
Medcost Setting Facility Modifier None Typical Low $6.17 Median $16.60 Typical High $24.55 | Facility | None | $6.17 | $16.60 | $24.55 |
Medcost Setting Professional Modifier None Typical Low $12.88 Median $15.85 Typical High $26.30 | Professional | None | $12.88 | $15.85 | $26.30 |
Molina Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
United Setting Professional Modifier None Typical Low $6.61 Median $9.55 Typical High $12.88 | Professional | None | $6.61 | $9.55 | $12.88 |
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 $2.04 Median $2.40 Typical High $2.40 | Professional | 55 · Aftercare only | $2.04 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.58 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.35 | $1.58 | $1.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.46 Median $7.94 Typical High $17.78 | Professional | 51 · Multiple procedures | $6.46 | $7.94 | $17.78 |
Where South Carolina sits
The same service costs 2.8 times more in Hawaii than in Connecticut. 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· 30th of 51
$12.88
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.