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 $4.17 Median $4.17 Typical High $4.17 | Facility | None | $4.17 | $4.17 | $4.17 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $4.17 Typical High $4.17 | Professional | None | $3.63 | $4.17 | $4.17 |
BCBS South Carolina Setting Facility Modifier None Typical Low $4.79 Median $5.37 Typical High $5.37 | Facility | None | $4.79 | $5.37 | $5.37 |
BCBS South Carolina Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
Medcost Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $3.39 | Professional | None | $2.63 | $2.63 | $3.39 |
Medcost Setting Facility Modifier None Typical Low $1.45 Median $4.37 Typical High $6.46 | Facility | None | $1.45 | $4.37 | $6.46 |
Medcost Setting Professional Modifier None Typical Low $3.02 Median $4.47 Typical High $7.08 | Professional | None | $3.02 | $4.47 | $7.08 |
Molina Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
United Setting Professional Modifier None Typical Low $1.74 Median $2.51 Typical High $3.24 | Professional | None | $1.74 | $2.51 | $3.24 |
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 $1.82 Median $2.09 Typical High $2.09 | Professional | 52 · Reduced service | $1.82 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.83 Typical High $0.83 | Professional | 53 · Discontinued | $0.72 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.55 Median $0.63 Typical High $0.63 | Professional | 55 · Aftercare only | $0.55 | $0.63 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.42 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.36 | $0.42 | $0.42 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.51 Median $2.24 Typical High $4.68 | Professional | 51 · Multiple procedures | $1.51 | $2.24 | $4.68 |
Where South Carolina sits
The same service costs 2.6 times more in Kansas than in New Hampshire. 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
$4.17
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.