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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $31.62 Typical High $31.62 | Professional | None | $27.54 | $31.62 | $31.62 |
BCBS South Carolina Setting Facility Modifier None Typical Low $36.31 Median $39.81 Typical High $39.81 | Facility | None | $36.31 | $39.81 | $39.81 |
BCBS South Carolina Setting Professional Modifier None Typical Low $26.92 Median $36.31 Typical High $39.81 | Professional | None | $26.92 | $36.31 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $26.30 | Professional | None | $16.22 | $22.39 | $26.30 |
Medcost Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $25.12 | Professional | None | $19.95 | $19.95 | $25.12 |
Medcost Setting Facility Modifier None Typical Low $10.72 Median $33.11 Typical High $48.98 | Facility | None | $10.72 | $33.11 | $48.98 |
Medcost Setting Professional Modifier None Typical Low $25.12 Median $30.20 Typical High $52.48 | Professional | None | $25.12 | $30.20 | $52.48 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
United Setting Professional Modifier None Typical Low $13.18 Median $18.62 Typical High $23.99 | Professional | None | $13.18 | $18.62 | $23.99 |
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 $4.07 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.07 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.69 | $3.16 | $3.16 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.59 Median $15.49 Typical High $34.67 | Professional | 51 · Multiple procedures | $12.59 | $15.49 | $34.67 |
Where South Carolina sits
The same service costs 3.0 times more in Hawaii than in Kansas. 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· 20th of 51
$26.92
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.