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 $2.29 Median $2.29 Typical High $2.29 | Facility | None | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier None Typical Low $1.74 Median $2.29 Typical High $2.29 | Professional | None | $1.74 | $2.29 | $2.29 |
Ambetter Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2.63 Median $2.95 Typical High $2.95 | Facility | None | $2.63 | $2.95 | $2.95 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1.78 Median $2.95 Typical High $7.08 | Professional | None | $1.78 | $2.95 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $2.14 | Facility | None | $1.74 | $1.74 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $2.14 | Professional | None | $1.48 | $1.48 | $2.14 |
Medcost Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.86 | Professional | None | $1.45 | $1.45 | $1.86 |
Medcost Setting Facility Modifier None Typical Low $0.79 Median $2.40 Typical High $3.55 | Facility | None | $0.79 | $2.40 | $3.55 |
Medcost Setting Professional Modifier None Typical Low $2.00 Median $2.45 Typical High $3.80 | Professional | None | $2.00 | $2.45 | $3.80 |
Molina Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | None | $1.62 | $1.62 | $1.62 |
United Setting Professional Modifier None Typical Low $0.95 Median $1.38 Typical High $1.78 | Professional | None | $0.95 | $1.38 | $1.78 |
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 $1.00 Median $1.15 Typical High $1.15 | Professional | 52 · Reduced service | $1.00 | $1.15 | $1.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.46 Typical High $0.46 | Professional | 53 · Discontinued | $0.40 | $0.46 | $0.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.35 Typical High $0.35 | Professional | 55 · Aftercare only | $0.30 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.23 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.20 | $0.23 | $0.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.00 Median $1.23 Typical High $2.57 | Professional | 51 · Multiple procedures | $1.00 | $1.23 | $2.57 |
Where South Carolina sits
The same service costs 2.2 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· 4th of 51
$2.95
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.