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 $12.88 Median $12.88 Typical High $16.22 | Facility | None | $12.88 | $12.88 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $13.18 | Professional | None | $12.88 | $12.88 | $13.18 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $66.07 Typical High $66.07 | Professional | None | $48.98 | $66.07 | $66.07 |
BCBS South Carolina Setting Facility Modifier None Typical Low $21.88 Median $36.31 Typical High $251.19 | Facility | None | $21.88 | $36.31 | $251.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $13.80 Median $15.49 Typical High $16.98 | Professional | None | $13.80 | $15.49 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $25.70 Typical High $32.36 | Facility | None | $15.14 | $25.70 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Medcost Setting Facility Modifier None Typical Low $12.88 Median $15.49 Typical High $17.38 | Facility | None | $12.88 | $15.49 | $17.38 |
Medcost Setting Professional Modifier None Typical Low $15.49 Median $25.12 Typical High $28.84 | Professional | None | $15.49 | $25.12 | $28.84 |
Molina Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $13.49 | Professional | None | $10.72 | $10.72 | $13.49 |
United Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $14.45 | Professional | None | $12.88 | $12.88 | $14.45 |
4 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 $6.46 Median $6.46 Typical High $6.61 | Professional | 52 · Reduced service | $6.46 | $6.46 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.57 Typical High $2.63 | Professional | 53 · Discontinued | $2.57 | $2.57 | $2.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $1.91 Typical High $2.00 | Professional | 55 · Aftercare only | $1.91 | $1.91 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $1.32 |
Where South Carolina sits
The same service costs 11.0 times more in Kansas than in New York. 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· 26th of 51
$13.80
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.