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 $11.22 Median $11.22 Typical High $11.22 | Facility | None | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
BCBS South Carolina Setting Facility Modifier None Typical Low $12.88 Median $14.45 Typical High $14.45 | Facility | None | $12.88 | $14.45 | $14.45 |
BCBS South Carolina Setting Professional Modifier None Typical Low $8.71 Median $10.00 Typical High $14.45 | Professional | None | $8.71 | $10.00 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $10.00 | Professional | None | $8.51 | $8.51 | $10.00 |
Medcost Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $10.72 | Professional | None | $8.32 | $8.32 | $10.72 |
Medcost Setting Facility Modifier None Typical Low $4.57 Median $11.75 Typical High $17.38 | Facility | None | $4.57 | $11.75 | $17.38 |
Medcost Setting Professional Modifier None Typical Low $10.00 Median $10.96 Typical High $19.05 | Professional | None | $10.00 | $10.96 | $19.05 |
Molina Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
United Setting Professional Modifier None Typical Low $5.37 Median $6.92 Typical High $9.12 | Professional | None | $5.37 | $6.92 | $9.12 |
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 $1.70 Median $1.70 Typical High $1.70 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.01 Median $5.50 Typical High $12.59 | Professional | 51 · Multiple procedures | $5.01 | $5.50 | $12.59 |
Where South Carolina sits
The same service costs 2.3 times more in Montana than in Connecticut. 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· 29th 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.