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 $12.59 Median $12.59 Typical High $12.59 | Facility | None | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $12.59 Typical High $12.59 | Professional | None | $10.00 | $12.59 | $12.59 |
BCBS South Carolina Setting Facility Modifier None Typical Low $14.45 Median $16.22 Typical High $16.22 | Facility | None | $14.45 | $16.22 | $16.22 |
BCBS South Carolina Setting Professional Modifier None Typical Low $9.77 Median $10.96 Typical High $16.22 | Professional | None | $9.77 | $10.96 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $9.55 Typical High $9.55 | Facility | None | $8.13 | $9.55 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.55 | Professional | None | $8.13 | $8.13 | $9.55 |
Medcost Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $10.23 | Professional | None | $7.94 | $7.94 | $10.23 |
Medcost Setting Facility Modifier None Typical Low $4.37 Median $13.18 Typical High $19.50 | Facility | None | $4.37 | $13.18 | $19.50 |
Medcost Setting Professional Modifier None Typical Low $10.00 Median $12.02 Typical High $20.89 | Professional | None | $10.00 | $12.02 | $20.89 |
United Setting Professional Modifier None Typical Low $5.25 Median $7.59 Typical High $9.55 | Professional | None | $5.25 | $7.59 | $9.55 |
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 $1.62 Median $1.91 Typical High $1.91 | Professional | 55 · Aftercare only | $1.62 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.26 Typical High $1.26 | Professional | 56 · Pre-op care only | $1.10 | $1.26 | $1.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.01 Median $6.46 Typical High $14.13 | Professional | 51 · Multiple procedures | $5.01 | $6.46 | $14.13 |
Where South Carolina sits
The same service costs 2.2 times more in Kansas 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· 21st of 51
$10.96
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.