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 $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $7.59 Typical High $7.59 | Professional | None | $5.75 | $7.59 | $7.59 |
Ambetter Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
BCBS South Carolina Setting Facility Modifier None Typical Low $8.71 Median $9.77 Typical High $9.77 | Facility | None | $8.71 | $9.77 | $9.77 |
BCBS South Carolina Setting Professional Modifier None Typical Low $7.08 Median $8.71 Typical High $9.77 | Professional | None | $7.08 | $8.71 | $9.77 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.61 | Facility | None | $6.17 | $6.17 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.61 | Professional | None | $5.25 | $5.25 | $6.61 |
Medcost Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $6.61 | Professional | None | $4.68 | $4.68 | $6.61 |
Medcost Setting Facility Modifier None Typical Low $2.82 Median $7.59 Typical High $11.75 | Facility | None | $2.82 | $7.59 | $11.75 |
Medcost Setting Professional Modifier None Typical Low $6.03 Median $7.24 Typical High $10.96 | Professional | None | $6.03 | $7.24 | $10.96 |
Molina Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
United Setting Professional Modifier None Typical Low $3.39 Median $4.57 Typical High $5.89 | Professional | None | $3.39 | $4.57 | $5.89 |
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 $0.98 Median $1.15 Typical High $1.15 | Professional | 55 · Aftercare only | $0.98 | $1.15 | $1.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $0.78 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.65 | $0.78 | $0.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.02 Median $3.98 Typical High $8.51 | Professional | 51 · Multiple procedures | $3.02 | $3.98 | $8.51 |
Where South Carolina sits
The same service costs 2.1 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· 18th of 51
$7.08
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.