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 $6.46 Median $6.46 Typical High $6.46 | Facility | None | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $6.46 Typical High $6.46 | Professional | None | $4.79 | $6.46 | $6.46 |
Ambetter Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $7.41 Median $8.13 Typical High $8.13 | Facility | None | $7.41 | $8.13 | $8.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $5.75 Median $7.41 Typical High $8.13 | Professional | None | $5.75 | $7.41 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $5.13 | Facility | None | $4.79 | $4.79 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $5.13 | Professional | None | $4.07 | $4.07 | $5.13 |
Medcost Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $5.13 | Professional | None | $3.98 | $3.98 | $5.13 |
Medcost Setting Facility Modifier None Typical Low $2.19 Median $6.76 Typical High $9.77 | Facility | None | $2.19 | $6.76 | $9.77 |
Medcost Setting Professional Modifier None Typical Low $5.01 Median $6.46 Typical High $9.12 | Professional | None | $5.01 | $6.46 | $9.12 |
Molina Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
United Setting Professional Modifier None Typical Low $2.63 Median $3.80 Typical High $4.90 | Professional | None | $2.63 | $3.80 | $4.90 |
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 $0.83 Median $0.95 Typical High $0.95 | Professional | 55 · Aftercare only | $0.83 | $0.95 | $0.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.65 Typical High $0.65 | Professional | 56 · Pre-op care only | $0.55 | $0.65 | $0.65 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.51 Median $3.39 Typical High $7.08 | Professional | 51 · Multiple procedures | $2.51 | $3.39 | $7.08 |
Where South Carolina sits
The same service costs 2.3 times more in Kansas than in Utah. 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· 21st of 51
$5.75
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.