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 $1.86 Median $1.86 Typical High $1.86 | Facility | None | $1.86 | $1.86 | $1.86 |
Aetna Setting Professional Modifier None Typical Low $1.55 Median $1.86 Typical High $1.86 | Professional | None | $1.55 | $1.86 | $1.86 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2.14 Median $2.40 Typical High $2.40 | Facility | None | $2.14 | $2.40 | $2.40 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2.00 Median $2.40 Typical High $2.40 | Professional | None | $2.00 | $2.40 | $2.40 |
Cigna Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.74 | Facility | None | $1.41 | $1.41 | $1.74 |
Cigna Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.74 | Professional | None | $1.20 | $1.20 | $1.74 |
Medcost Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.38 | Professional | None | $1.17 | $1.17 | $1.38 |
Medcost Setting Facility Modifier None Typical Low $0.65 Median $1.86 Typical High $2.88 | Facility | None | $0.65 | $1.86 | $2.88 |
Medcost Setting Professional Modifier None Typical Low $1.00 Median $1.78 Typical High $2.69 | Professional | None | $1.00 | $1.78 | $2.69 |
Molina Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
United Setting Professional Modifier None Typical Low $0.78 Median $1.12 Typical High $1.45 | Professional | None | $0.78 | $1.12 | $1.45 |
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 $0.24 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.24 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.17 | $0.19 | $0.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.50 Median $1.00 Typical High $2.09 | Professional | 51 · Multiple procedures | $0.50 | $1.00 | $2.09 |
Where South Carolina sits
The same service costs 5.4 times more in Kansas than in Kentucky. 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· 12th of 51
$2.00
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.