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 $7.24 Median $7.24 Typical High $7.24 | Facility | None | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier None Typical Low $6.31 Median $7.24 Typical High $7.24 | Professional | None | $6.31 | $7.24 | $7.24 |
BCBS South Carolina Setting Facility Modifier None Typical Low $8.32 Median $9.33 Typical High $9.33 | Facility | None | $8.32 | $9.33 | $9.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $7.08 Median $8.71 Typical High $9.33 | Professional | None | $7.08 | $8.71 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.75 | Facility | None | $5.50 | $5.50 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $5.75 | Professional | None | $4.68 | $4.68 | $5.75 |
Medcost Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $5.89 | Professional | None | $4.57 | $4.57 | $5.89 |
Medcost Setting Facility Modifier None Typical Low $2.51 Median $7.59 Typical High $11.22 | Facility | None | $2.51 | $7.59 | $11.22 |
Medcost Setting Professional Modifier None Typical Low $6.03 Median $7.08 Typical High $10.47 | Professional | None | $6.03 | $7.08 | $10.47 |
Molina Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
United Setting Professional Modifier None Typical Low $3.02 Median $4.37 Typical High $5.50 | Professional | None | $3.02 | $4.37 | $5.50 |
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 $3.16 Median $3.63 Typical High $3.63 | Professional | 52 · Reduced service | $3.16 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.26 Median $1.45 Typical High $1.45 | Professional | 53 · Discontinued | $1.26 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.95 Median $1.10 Typical High $1.10 | Professional | 55 · Aftercare only | $0.95 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.63 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.63 | $0.72 | $0.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.02 Median $3.47 Typical High $8.13 | Professional | 51 · Multiple procedures | $3.02 | $3.47 | $8.13 |
Where South Carolina sits
The same service costs 2.3 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· 17th of 51
$7.08
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.