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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $52.48 | Professional | None | $39.81 | $52.48 | $52.48 |
Ambetter Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
BCBS South Carolina Setting Facility Modifier None Typical Low $60.26 Median $67.61 Typical High $67.61 | Facility | None | $60.26 | $67.61 | $67.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $41.69 Median $42.66 Typical High $67.61 | Professional | None | $41.69 | $42.66 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $48.98 | Facility | None | $39.81 | $39.81 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $48.98 | Professional | None | $33.88 | $33.88 | $48.98 |
Medcost Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $42.66 | Professional | None | $33.11 | $33.11 | $42.66 |
Medcost Setting Facility Modifier None Typical Low $18.20 Median $56.23 Typical High $81.28 | Facility | None | $18.20 | $56.23 | $81.28 |
Medcost Setting Professional Modifier None Typical Low $42.66 Median $50.12 Typical High $89.13 | Professional | None | $42.66 | $50.12 | $89.13 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $21.88 Median $31.62 Typical High $40.74 | Professional | None | $21.88 | $31.62 | $40.74 |
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 $22.91 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $22.91 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $9.12 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $6.92 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.57 | $5.25 | $5.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $21.38 Median $25.12 Typical High $58.88 | Professional | 51 · Multiple procedures | $21.38 | $25.12 | $58.88 |
Where South Carolina sits
The same service costs 2.3 times more in Kansas than in Alabama. 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· 33rd of 51
$42.66
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.