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 $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $10.00 Typical High $10.00 | Professional | None | $7.94 | $10.00 | $10.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $11.48 Median $12.88 Typical High $12.88 | Facility | None | $11.48 | $12.88 | $12.88 |
BCBS South Carolina Setting Professional Modifier None Typical Low $8.91 Median $11.48 Typical High $12.88 | Professional | None | $8.91 | $11.48 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.94 | Facility | None | $7.59 | $7.59 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $7.94 | Professional | None | $6.46 | $6.46 | $7.94 |
Medcost Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $8.13 | Professional | None | $6.31 | $6.31 | $8.13 |
Medcost Setting Facility Modifier None Typical Low $3.47 Median $10.72 Typical High $15.49 | Facility | None | $3.47 | $10.72 | $15.49 |
Medcost Setting Professional Modifier None Typical Low $7.94 Median $10.00 Typical High $14.79 | Professional | None | $7.94 | $10.00 | $14.79 |
Molina Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
United Setting Professional Modifier None Typical Low $4.17 Median $6.03 Typical High $7.76 | Professional | None | $4.17 | $6.03 | $7.76 |
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 $1.32 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.32 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.87 | $1.00 | $1.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.98 Median $5.01 Typical High $11.22 | Professional | 51 · Multiple procedures | $3.98 | $5.01 | $11.22 |
Where South Carolina sits
The same service costs 2.1 times more in Idaho than in New Jersey. 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
$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.