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 $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $5.37 Typical High $5.37 | Professional | None | $4.37 | $5.37 | $5.37 |
Ambetter Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
BCBS South Carolina Setting Facility Modifier None Typical Low $6.17 Median $6.76 Typical High $6.76 | Facility | None | $6.17 | $6.76 | $6.76 |
BCBS South Carolina Setting Professional Modifier None Typical Low $5.01 Median $6.17 Typical High $6.76 | Professional | None | $5.01 | $6.17 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $4.27 | Facility | None | $3.98 | $3.98 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $4.27 | Professional | None | $3.39 | $3.39 | $4.27 |
Medcost Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $4.27 | Professional | None | $3.31 | $3.31 | $4.27 |
Medcost Setting Facility Modifier None Typical Low $1.82 Median $5.62 Typical High $8.13 | Facility | None | $1.82 | $5.62 | $8.13 |
Medcost Setting Professional Modifier None Typical Low $3.98 Median $5.62 Typical High $7.59 | Professional | None | $3.98 | $5.62 | $7.59 |
Molina Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
United Setting Professional Modifier None Typical Low $2.19 Median $3.16 Typical High $4.07 | Professional | None | $2.19 | $3.16 | $4.07 |
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 $2.29 Median $2.63 Typical High $2.63 | Professional | 52 · Reduced service | $2.29 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.91 Median $1.07 Typical High $1.07 | Professional | 53 · Discontinued | $0.91 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.69 Median $0.79 Typical High $0.79 | Professional | 55 · Aftercare only | $0.69 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.46 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.46 | $0.52 | $0.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.00 Median $2.82 Typical High $5.89 | Professional | 51 · Multiple procedures | $2.00 | $2.82 | $5.89 |
Where South Carolina sits
The same service costs 2.1 times more in Kansas than in Alabama. 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
$5.01
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.