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 $2.04 Median $2.04 Typical High $2.04 | Facility | None | $2.04 | $2.04 | $2.04 |
Aetna Setting Professional Modifier None Typical Low $1.70 Median $2.04 Typical High $2.04 | Professional | None | $1.70 | $2.04 | $2.04 |
Ambetter Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | None | $1.66 | $1.66 | $1.66 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2.40 Median $2.63 Typical High $2.63 | Facility | None | $2.40 | $2.63 | $2.63 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1.82 Median $2.40 Typical High $2.63 | Professional | None | $1.82 | $2.40 | $2.63 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.66 | Facility | None | $1.55 | $1.55 | $1.66 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.66 | Professional | None | $1.32 | $1.32 | $1.66 |
Medcost Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.66 | Professional | None | $1.29 | $1.29 | $1.66 |
Medcost Setting Facility Modifier None Typical Low $0.71 Median $2.19 Typical High $3.24 | Facility | None | $0.71 | $2.19 | $3.24 |
Medcost Setting Professional Modifier None Typical Low $1.95 Median $2.00 Typical High $2.95 | Professional | None | $1.95 | $2.00 | $2.95 |
Molina Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
United Setting Professional Modifier None Typical Low $0.85 Median $1.23 Typical High $1.58 | Professional | None | $0.85 | $1.23 | $1.58 |
5 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 52 · Reduced service Typical Low $0.89 Median $1.05 Typical High $1.05 | Professional | 52 · Reduced service | $0.89 | $1.05 | $1.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.36 Median $0.41 Typical High $0.41 | Professional | 53 · Discontinued | $0.36 | $0.41 | $0.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.31 Typical High $0.31 | Professional | 55 · Aftercare only | $0.27 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.21 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.18 | $0.21 | $0.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.98 Median $1.00 Typical High $2.29 | Professional | 51 · Multiple procedures | $0.98 | $1.00 | $2.29 |
Where South Carolina sits
The same service costs 2.3 times more in Kansas 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· 23rd of 51
$1.82
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.