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 $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $10.72 Typical High $10.72 | Professional | None | $8.32 | $10.72 | $10.72 |
Ambetter Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
BCBS South Carolina Setting Facility Modifier None Typical Low $12.30 Median $13.80 Typical High $13.80 | Facility | None | $12.30 | $13.80 | $13.80 |
BCBS South Carolina Setting Professional Modifier None Typical Low $8.32 Median $10.00 Typical High $13.80 | Professional | None | $8.32 | $10.00 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.51 | Facility | None | $8.13 | $8.13 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $8.51 | Professional | None | $6.92 | $6.92 | $8.51 |
Medcost Setting Facility Modifier None Typical Low $8.32 Median $11.22 Typical High $16.60 | Facility | None | $8.32 | $11.22 | $16.60 |
Medcost Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $17.78 | Professional | None | $10.47 | $10.47 | $17.78 |
Molina Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
United Setting Professional Modifier None Typical Low $4.47 Median $6.46 Typical High $8.71 | Professional | None | $4.47 | $6.46 | $8.71 |
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 $4.68 Median $5.37 Typical High $5.37 | Professional | 52 · Reduced service | $4.68 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $2.14 Typical High $2.14 | Professional | 53 · Discontinued | $1.86 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.38 Median $1.62 Typical High $1.62 | Professional | 55 · Aftercare only | $1.38 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $1.07 Typical High $1.07 | Professional | 56 · Pre-op care only | $0.93 | $1.07 | $1.07 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.25 Median $5.25 Typical High $11.75 | Professional | 51 · Multiple procedures | $5.25 | $5.25 | $11.75 |
Where South Carolina sits
The same service costs 2.2 times more in Hawaii than in Maine. 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· 18th of 51
$10.00
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.