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 $3.98 Median $3.98 Typical High $3.98 | Facility | None | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.98 Typical High $3.98 | Professional | None | $3.09 | $3.98 | $3.98 |
Ambetter Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
BCBS South Carolina Setting Facility Modifier None Typical Low $4.57 Median $5.13 Typical High $5.13 | Facility | None | $4.57 | $5.13 | $5.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $3.98 Median $4.79 Typical High $5.13 | Professional | None | $3.98 | $4.79 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.16 | Facility | None | $3.02 | $3.02 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.16 | Professional | None | $2.57 | $2.57 | $3.16 |
Medcost Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $3.24 | Professional | None | $2.51 | $2.51 | $3.24 |
Medcost Setting Facility Modifier None Typical Low $1.38 Median $4.17 Typical High $6.17 | Facility | None | $1.38 | $4.17 | $6.17 |
Medcost Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $5.75 | Professional | None | $3.02 | $3.98 | $5.75 |
Molina Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
United Setting Professional Modifier None Typical Low $1.66 Median $2.40 Typical High $3.02 | Professional | None | $1.66 | $2.40 | $3.02 |
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 $1.74 Median $2.00 Typical High $2.00 | Professional | 52 · Reduced service | $1.74 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.69 Median $0.79 Typical High $0.79 | Professional | 53 · Discontinued | $0.69 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.60 Typical High $0.60 | Professional | 55 · Aftercare only | $0.52 | $0.60 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.40 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.35 | $0.40 | $0.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.51 Median $2.00 Typical High $4.47 | Professional | 51 · Multiple procedures | $1.51 | $2.00 | $4.47 |
Where South Carolina sits
The same service costs 2.3 times more in Kansas than in Connecticut. 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· 16th of 51
$3.98
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.