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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $47.86 | Professional | None | $33.11 | $43.65 | $47.86 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $57.54 | Professional | None | $38.90 | $38.90 | $57.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $50.12 Median $54.95 Typical High $54.95 | Facility | None | $50.12 | $54.95 | $54.95 |
BCBS South Carolina Setting Professional Modifier None Typical Low $33.11 Median $50.12 Typical High $54.95 | Professional | None | $33.11 | $50.12 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $35.48 | Professional | None | $25.70 | $25.70 | $35.48 |
Medcost Setting Facility Modifier None Typical Low $35.48 Median $45.71 Typical High $66.07 | Facility | None | $35.48 | $45.71 | $66.07 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $72.44 | Professional | None | $44.67 | $44.67 | $72.44 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
United Setting Professional Modifier None Typical Low $17.78 Median $26.30 Typical High $37.15 | Professional | None | $17.78 | $26.30 | $37.15 |
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 $18.62 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $18.62 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $7.41 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $5.62 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.72 | $4.37 | $4.37 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.39 Median $22.39 Typical High $47.86 | Professional | 51 · Multiple procedures | $22.39 | $22.39 | $47.86 |
Where South Carolina sits
The same service costs 2.2 times more in Hawaii than in Utah. 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· 24th of 51
$38.90
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.