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 $1.95 Median $1.95 Typical High $1.95 | Facility | None | $1.95 | $1.95 | $1.95 |
Aetna Setting Professional Modifier None Typical Low $1.51 Median $1.95 Typical High $2.14 | Professional | None | $1.51 | $1.95 | $2.14 |
Ambetter Setting Professional Modifier None Typical Low $1.05 Median $1.05 Typical High $2.51 | Professional | None | $1.05 | $1.05 | $2.51 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1.74 Median $2.51 Typical High $2.51 | Professional | None | $1.74 | $2.51 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Medcost Setting Facility Modifier None Typical Low $1.74 Median $1.95 Typical High $6.92 | Facility | None | $1.74 | $1.95 | $6.92 |
Medcost Setting Professional Modifier None Typical Low $1.82 Median $2.00 Typical High $3.24 | Professional | None | $1.82 | $2.00 | $3.24 |
United Setting Professional Modifier None Typical Low $0.87 Median $1.23 Typical High $1.58 | Professional | None | $0.87 | $1.23 | $1.58 |
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 $0.81 Median $0.98 Typical High $1.07 | Professional | 52 · Reduced service | $0.81 | $0.98 | $1.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.39 Typical High $0.43 | Professional | 53 · Discontinued | $0.32 | $0.39 | $0.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.25 Median $0.28 Typical High $0.32 | Professional | 55 · Aftercare only | $0.25 | $0.28 | $0.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.20 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.16 | $0.20 | $0.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.91 Median $1.00 Typical High $2.09 | Professional | 51 · Multiple procedures | $0.91 | $1.00 | $2.09 |
Where South Carolina sits
The same service costs 2.6 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· 16th of 51
$1.95
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.