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 $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $4.17 | Professional | None | $3.39 | $3.39 | $4.17 |
BCBS South Carolina Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $134.90 | Facility | None | $72.44 | $72.44 | $134.90 |
BCBS South Carolina Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.25 | Professional | None | $5.01 | $5.01 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $7.08 Typical High $9.12 | Facility | None | $4.17 | $7.08 | $9.12 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Medcost Setting Facility Modifier None Typical Low $3.39 Median $4.07 Typical High $4.57 | Facility | None | $3.39 | $4.07 | $4.57 |
Medcost Setting Professional Modifier None Typical Low $0.33 Median $0.33 Typical High $2.82 | Professional | None | $0.33 | $0.33 | $2.82 |
United Setting Professional Modifier None Typical Low $1.58 Median $2.63 Typical High $7.59 | Professional | None | $1.58 | $2.63 | $7.59 |
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 $1.70 Median $1.70 Typical High $2.09 | Professional | 52 · Reduced service | $1.70 | $1.70 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.68 Typical High $0.83 | Professional | 53 · Discontinued | $0.68 | $0.68 | $0.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.50 Typical High $0.63 | Professional | 55 · Aftercare only | $0.50 | $0.50 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.34 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.34 | $0.34 | $0.42 |
Where South Carolina sits
The same service costs 4.6 times more in Ohio than in Hawaii. 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· 47th of 51
$3.72
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.