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 $9.77 Median $9.77 Typical High $9.77 | Facility | None | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $9.77 Typical High $9.77 | Professional | None | $7.59 | $9.77 | $9.77 |
Ambetter Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
BCBS South Carolina Setting Facility Modifier None Typical Low $11.22 Median $12.59 Typical High $12.59 | Facility | None | $11.22 | $12.59 | $12.59 |
BCBS South Carolina Setting Professional Modifier None Typical Low $8.91 Median $11.22 Typical High $12.59 | Professional | None | $8.91 | $11.22 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $7.76 | Facility | None | $7.41 | $7.41 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $7.76 | Professional | None | $6.31 | $6.31 | $7.76 |
Medcost Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $7.94 | Professional | None | $6.17 | $6.17 | $7.94 |
Medcost Setting Facility Modifier None Typical Low $3.39 Median $10.23 Typical High $15.14 | Facility | None | $3.39 | $10.23 | $15.14 |
Medcost Setting Professional Modifier None Typical Low $7.94 Median $10.00 Typical High $14.13 | Professional | None | $7.94 | $10.00 | $14.13 |
Molina Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
United Setting Professional Modifier None Typical Low $4.07 Median $5.89 Typical High $7.41 | Professional | None | $4.07 | $5.89 | $7.41 |
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 $1.26 Median $1.48 Typical High $1.48 | Professional | 55 · Aftercare only | $1.26 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.98 Typical High $0.98 | Professional | 56 · Pre-op care only | $0.85 | $0.98 | $0.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.98 Median $5.01 Typical High $10.72 | Professional | 51 · Multiple procedures | $3.98 | $5.01 | $10.72 |
Where South Carolina sits
The same service costs 2.0 times more in Montana than in Florida. 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· 19th of 51
$8.91
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.