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 $2.69 Median $2.69 Typical High $2.69 | Facility | None | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier None Typical Low $2.09 Median $2.69 Typical High $2.69 | Professional | None | $2.09 | $2.69 | $2.69 |
Ambetter Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3.09 Median $3.47 Typical High $3.47 | Facility | None | $3.09 | $3.47 | $3.47 |
BCBS South Carolina Setting Professional Modifier None Typical Low $3.02 Median $3.47 Typical High $3.63 | Professional | None | $3.02 | $3.47 | $3.63 |
Cigna Setting Facility Modifier None Typical Low $1.82 Median $2.04 Typical High $2.04 | Facility | None | $1.82 | $2.04 | $2.04 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.04 | Professional | None | $1.74 | $1.74 | $2.04 |
Medcost Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $2.19 | Professional | None | $1.70 | $1.70 | $2.19 |
Medcost Setting Facility Modifier None Typical Low $0.93 Median $2.82 Typical High $4.17 | Facility | None | $0.93 | $2.82 | $4.17 |
Medcost Setting Professional Modifier None Typical Low $2.00 Median $2.88 Typical High $4.57 | Professional | None | $2.00 | $2.88 | $4.57 |
Molina Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
United Setting Professional Modifier None Typical Low $1.12 Median $1.62 Typical High $2.04 | Professional | None | $1.12 | $1.62 | $2.04 |
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 $0.35 Median $0.41 Typical High $0.41 | Professional | 55 · Aftercare only | $0.35 | $0.41 | $0.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.24 Median $0.27 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.24 | $0.27 | $0.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.00 Median $1.45 Typical High $3.02 | Professional | 51 · Multiple procedures | $1.00 | $1.45 | $3.02 |
Where South Carolina sits
The same service costs 3.8 times more in Kansas than in Alabama. 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· 5th of 51
$3.02
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.