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 $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $3.80 Typical High $3.80 | Professional | None | $2.82 | $3.80 | $3.80 |
Ambetter Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
BCBS South Carolina Setting Facility Modifier None Typical Low $4.37 Median $4.79 Typical High $4.79 | Facility | None | $4.37 | $4.79 | $4.79 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2.95 Median $4.79 Typical High $7.08 | Professional | None | $2.95 | $4.79 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.82 Typical High $3.09 | Facility | None | $2.69 | $2.82 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.82 | Professional | None | $2.40 | $2.40 | $2.82 |
Medcost Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $3.02 | Professional | None | $2.34 | $2.34 | $3.02 |
Medcost Setting Facility Modifier None Typical Low $1.29 Median $3.98 Typical High $5.89 | Facility | None | $1.29 | $3.98 | $5.89 |
Medcost Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $6.31 | Professional | None | $3.02 | $3.98 | $6.31 |
Molina Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | None | $2.63 | $2.63 | $2.63 |
United Setting Professional Modifier None Typical Low $1.58 Median $2.24 Typical High $2.88 | Professional | None | $1.58 | $2.24 | $2.88 |
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 $1.62 Median $1.91 Typical High $1.91 | Professional | 52 · Reduced service | $1.62 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.66 Median $0.76 Typical High $0.76 | Professional | 53 · Discontinued | $0.66 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.56 Typical High $0.56 | Professional | 55 · Aftercare only | $0.49 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.38 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.33 | $0.38 | $0.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.51 Median $2.00 Typical High $4.17 | Professional | 51 · Multiple procedures | $1.51 | $2.00 | $4.17 |
Where South Carolina sits
The same service costs 2.2 times more in Kansas than in New Jersey. 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· 5th of 51
$4.79
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.