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 $4.57 Median $4.57 Typical High $4.57 | Facility | None | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $4.57 Typical High $4.57 | Professional | None | $4.17 | $4.57 | $4.57 |
Ambetter Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $5.89 Median $6.17 Typical High $6.31 | Professional | None | $5.89 | $6.17 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | None | $1.62 | $1.62 | $1.62 |
Medcost Setting Facility Modifier None Typical Low $4.57 Median $5.75 Typical High $7.41 | Facility | None | $4.57 | $5.75 | $7.41 |
Medcost Setting Professional Modifier None Typical Low $3.16 Median $8.91 Typical High $8.91 | Professional | None | $3.16 | $8.91 | $8.91 |
United Setting Professional Modifier None Typical Low $1.48 Median $5.62 Typical High $8.71 | Professional | None | $1.48 | $5.62 | $8.71 |
2 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 55 · Aftercare only Typical Low $0.63 Median $0.69 Typical High $0.69 | Professional | 55 · Aftercare only | $0.63 | $0.69 | $0.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.46 Typical High $0.46 | Professional | 56 · Pre-op care only | $0.42 | $0.46 | $0.46 |
Where South Carolina sits
The same service costs 5.2 times more in Kansas than in Delaware. 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· 7th of 51
$6.17
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.