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 $3.16 Median $3.16 Typical High $3.16 | Facility | None | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier None Typical Low $2.57 Median $3.16 Typical High $3.16 | Professional | None | $2.57 | $3.16 | $3.16 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3.63 Median $3.98 Typical High $3.98 | Facility | None | $3.63 | $3.98 | $3.98 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2.45 Median $3.02 Typical High $3.98 | Professional | None | $2.45 | $3.02 | $3.98 |
Cigna Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Facility | None | $2.57 | $2.57 | $2.57 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $2.19 Typical High $2.57 | Professional | None | $1.91 | $2.19 | $2.57 |
Medcost Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.95 | Professional | None | $1.95 | $1.95 | $2.95 |
Medcost Setting Facility Modifier None Typical Low $1.26 Median $3.31 Typical High $5.01 | Facility | None | $1.26 | $3.31 | $5.01 |
Medcost Setting Professional Modifier None Typical Low $2.95 Median $3.31 Typical High $5.25 | Professional | None | $2.95 | $3.31 | $5.25 |
Molina Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
United Setting Professional Modifier None Typical Low $1.51 Median $1.95 Typical High $2.51 | Professional | None | $1.51 | $1.95 | $2.51 |
3 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 55 · Aftercare only Typical Low $0.42 Median $0.47 Typical High $0.47 | Professional | 55 · Aftercare only | $0.42 | $0.47 | $0.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.32 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.28 | $0.32 | $0.32 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.48 Median $1.66 Typical High $3.47 | Professional | 51 · Multiple procedures | $1.48 | $1.66 | $3.47 |
Where South Carolina sits
The same service costs 2.5 times more in Hawaii than in Vermont. 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· 21st of 51
$3.02
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.