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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $87.10 | Professional | None | $74.13 | $87.10 | $87.10 |
BCBS South Carolina Setting Facility Modifier None Typical Low $100.00 Median $109.65 Typical High $109.65 | Facility | None | $100.00 | $109.65 | $109.65 |
BCBS South Carolina Setting Professional Modifier None Typical Low $67.61 Median $77.62 Typical High $109.65 | Professional | None | $67.61 | $77.62 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $125.89 | Professional | None | $44.67 | $44.67 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $69.18 | Professional | None | $53.70 | $53.70 | $69.18 |
Medcost Setting Facility Modifier None Typical Low $29.51 Median $91.20 Typical High $134.90 | Facility | None | $29.51 | $91.20 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $81.28 Typical High $144.54 | Professional | None | $70.79 | $81.28 | $144.54 |
United Setting Professional Modifier None Typical Low $36.31 Median $51.29 Typical High $66.07 | Professional | None | $36.31 | $51.29 | $66.07 |
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 $37.15 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $37.15 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $14.79 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $11.22 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.41 | $8.71 | $8.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $34.67 Median $40.74 Typical High $95.50 | Professional | 51 · Multiple procedures | $34.67 | $40.74 | $95.50 |
Where South Carolina sits
The same service costs 2.5 times more in Idaho than in Colorado. 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
$77.62
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.