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 $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $10.96 Typical High $10.96 | Professional | None | $9.55 | $10.96 | $10.96 |
Ambetter Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
BCBS South Carolina Setting Facility Modifier None Typical Low $12.59 Median $14.13 Typical High $14.13 | Facility | None | $12.59 | $14.13 | $14.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $10.00 Median $12.59 Typical High $14.13 | Professional | None | $10.00 | $12.59 | $14.13 |
Cigna Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Facility | None | $8.32 | $8.32 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $8.32 | Professional | None | $7.08 | $7.08 | $8.32 |
Medcost Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $8.91 | Professional | None | $6.92 | $6.92 | $8.91 |
Medcost Setting Facility Modifier None Typical Low $3.80 Median $11.48 Typical High $16.98 | Facility | None | $3.80 | $11.48 | $16.98 |
Medcost Setting Professional Modifier None Typical Low $8.91 Median $10.96 Typical High $15.85 | Professional | None | $8.91 | $10.96 | $15.85 |
Molina Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
United Setting Professional Modifier None Typical Low $4.57 Median $6.61 Typical High $8.32 | Professional | None | $4.57 | $6.61 | $8.32 |
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 $1.45 Median $1.66 Typical High $1.66 | Professional | 55 · Aftercare only | $1.45 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.95 | $1.10 | $1.10 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $4.47 Median $5.50 Typical High $12.30 | Professional | 51 · Multiple procedures | $4.47 | $5.50 | $12.30 |
Where South Carolina sits
The same service costs 2.1 times more in Idaho than in Delaware. 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
$10.00
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.