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 $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $9.55 Typical High $9.55 | Professional | None | $8.32 | $9.55 | $9.55 |
BCBS South Carolina Setting Facility Modifier None Typical Low $10.96 Median $12.02 Typical High $12.02 | Facility | None | $10.96 | $12.02 | $12.02 |
BCBS South Carolina Setting Professional Modifier None Typical Low $8.51 Median $10.96 Typical High $12.02 | Professional | None | $8.51 | $10.96 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.59 | Facility | None | $7.08 | $7.08 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.59 | Professional | None | $6.03 | $6.03 | $7.59 |
Medcost Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.59 | Professional | None | $6.03 | $6.03 | $7.59 |
Medcost Setting Facility Modifier None Typical Low $3.24 Median $10.00 Typical High $14.79 | Facility | None | $3.24 | $10.00 | $14.79 |
Medcost Setting Professional Modifier None Typical Low $7.94 Median $10.00 Typical High $13.49 | Professional | None | $7.94 | $10.00 | $13.49 |
Molina Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $3.98 Median $5.62 Typical High $7.24 | Professional | None | $3.98 | $5.62 | $7.24 |
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 $4.07 Median $4.79 Typical High $4.79 | Professional | 52 · Reduced service | $4.07 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $1.91 Typical High $1.91 | Professional | 53 · Discontinued | $1.66 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.45 Typical High $1.45 | Professional | 55 · Aftercare only | $1.23 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.95 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.81 | $0.95 | $0.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.98 Median $5.01 Typical High $10.47 | Professional | 51 · Multiple procedures | $3.98 | $5.01 | $10.47 |
Where South Carolina sits
The same service costs 2.1 times more in Hawaii than in Delaware. 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· 22nd of 51
$8.51
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.