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 $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $9.33 Typical High $9.33 | Professional | None | $7.94 | $9.33 | $9.33 |
BCBS South Carolina Setting Facility Modifier None Typical Low $10.72 Median $11.75 Typical High $11.75 | Facility | None | $10.72 | $11.75 | $11.75 |
BCBS South Carolina Setting Professional Modifier None Typical Low $7.24 Median $7.94 Typical High $11.75 | Professional | None | $7.24 | $7.94 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $5.13 Typical High $5.89 | Professional | None | $5.01 | $5.13 | $5.89 |
Medcost Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $7.94 | Professional | None | $6.31 | $6.31 | $7.94 |
Medcost Setting Facility Modifier None Typical Low $3.39 Median $9.77 Typical High $14.45 | Facility | None | $3.39 | $9.77 | $14.45 |
Medcost Setting Professional Modifier None Typical Low $7.94 Median $8.91 Typical High $15.49 | Professional | None | $7.94 | $8.91 | $15.49 |
Molina Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
United Setting Professional Modifier None Typical Low $3.89 Median $5.62 Typical High $7.08 | Professional | None | $3.89 | $5.62 | $7.08 |
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 $1.20 Median $1.41 Typical High $1.41 | Professional | 55 · Aftercare only | $1.20 | $1.41 | $1.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $0.93 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.79 | $0.93 | $0.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.98 Median $4.47 Typical High $10.23 | Professional | 51 · Multiple procedures | $3.98 | $4.47 | $10.23 |
Where South Carolina sits
The same service costs 2.7 times more in Hawaii than in Vermont. 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· 18th of 51
$7.94
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.