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 $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $2.63 Median $4.07 Typical High $4.07 | Professional | None | $2.63 | $4.07 | $4.07 |
Ambetter Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
BCBS South Carolina Setting Facility Modifier None Typical Low $4.68 Median $5.25 Typical High $5.25 | Facility | None | $4.68 | $5.25 | $5.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $3.98 Median $4.90 Typical High $5.25 | Professional | None | $3.98 | $4.90 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $3.09 Median $3.09 Typical High $3.24 | Facility | None | $3.09 | $3.09 | $3.24 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.24 | Professional | None | $2.57 | $2.57 | $3.24 |
Medcost Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.31 | Professional | None | $2.57 | $2.57 | $3.31 |
Medcost Setting Facility Modifier None Typical Low $1.41 Median $4.27 Typical High $6.31 | Facility | None | $1.41 | $4.27 | $6.31 |
Medcost Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $6.76 | Professional | None | $3.02 | $3.98 | $6.76 |
Molina Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
United Setting Professional Modifier None Typical Low $1.70 Median $2.45 Typical High $3.09 | Professional | None | $1.70 | $2.45 | $3.09 |
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 $0.52 Median $0.62 Typical High $0.62 | Professional | 55 · Aftercare only | $0.52 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.41 Typical High $0.41 | Professional | 56 · Pre-op care only | $0.35 | $0.41 | $0.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.51 Median $2.00 Typical High $4.47 | Professional | 51 · Multiple procedures | $1.51 | $2.00 | $4.47 |
Where South Carolina sits
The same service costs 3.2 times more in Kansas than in Missouri. 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· 16th of 51
$3.98
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.