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 $6.61 Median $6.61 Typical High $6.61 | Facility | None | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $6.61 Typical High $6.61 | Professional | None | $5.50 | $6.61 | $6.61 |
BCBS South Carolina Setting Facility Modifier None Typical Low $7.59 Median $8.32 Typical High $8.32 | Facility | None | $7.59 | $8.32 | $8.32 |
BCBS South Carolina Setting Professional Modifier None Typical Low $5.13 Median $6.03 Typical High $8.32 | Professional | None | $5.13 | $6.03 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $7.24 | Facility | None | $5.75 | $5.75 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $7.24 | Professional | None | $4.90 | $4.90 | $7.24 |
Medcost Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $6.31 | Professional | None | $4.90 | $4.90 | $6.31 |
Medcost Setting Facility Modifier None Typical Low $2.63 Median $6.92 Typical High $10.23 | Facility | None | $2.63 | $6.92 | $10.23 |
Medcost Setting Professional Modifier None Typical Low $5.01 Median $6.76 Typical High $10.96 | Professional | None | $5.01 | $6.76 | $10.96 |
United Setting Professional Modifier None Typical Low $2.82 Median $4.07 Typical High $5.25 | Professional | None | $2.82 | $4.07 | $5.25 |
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 $3.31 Median $3.31 Typical High $3.31 | Professional | 52 · Reduced service | $3.31 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | 53 · Discontinued | $1.32 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 55 · Aftercare only | $1.00 | $1.00 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.66 Median $0.66 Typical High $0.66 | Professional | 56 · Pre-op care only | $0.66 | $0.66 | $0.66 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.51 Median $3.47 Typical High $7.24 | Professional | 51 · Multiple procedures | $2.51 | $3.47 | $7.24 |
Where South Carolina sits
The same service costs 2.5 times more in Montana 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· 23rd of 51
$6.03
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.