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 $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $46.77 Typical High $46.77 | Professional | None | $40.74 | $46.77 | $46.77 |
BCBS South Carolina Setting Facility Modifier None Typical Low $53.70 Median $60.26 Typical High $60.26 | Facility | None | $53.70 | $60.26 | $60.26 |
BCBS South Carolina Setting Professional Modifier None Typical Low $36.31 Median $38.02 Typical High $60.26 | Professional | None | $36.31 | $38.02 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $38.02 Typical High $38.02 | Facility | None | $34.67 | $38.02 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | None | $32.36 | $32.36 | $38.02 |
Medcost Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $40.74 | Professional | None | $31.62 | $31.62 | $40.74 |
Medcost Setting Facility Modifier None Typical Low $17.38 Median $48.98 Typical High $72.44 | Facility | None | $17.38 | $48.98 | $72.44 |
Medcost Setting Professional Modifier None Typical Low $40.74 Median $45.71 Typical High $77.62 | Professional | None | $40.74 | $45.71 | $77.62 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
United Setting Professional Modifier None Typical Low $19.50 Median $28.18 Typical High $37.15 | Professional | None | $19.50 | $28.18 | $37.15 |
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 $6.61 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $6.61 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.37 | $4.68 | $4.68 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $20.42 Median $22.91 Typical High $52.48 | Professional | 51 · Multiple procedures | $20.42 | $22.91 | $52.48 |
Where South Carolina sits
The same service costs 3.0 times more in Hawaii than in New Hampshire. 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· 26th of 51
$38.02
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.