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 $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $6.17 Typical High $6.17 | Professional | None | $5.75 | $6.17 | $6.17 |
BCBS South Carolina Setting Facility Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Facility | None | $7.76 | $7.76 | $7.76 |
BCBS South Carolina Setting Professional Modifier None Typical Low $7.76 Median $8.13 Typical High $8.13 | Professional | None | $7.76 | $8.13 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Medcost Setting Facility Modifier None Typical Low $6.17 Median $7.59 Typical High $9.55 | Facility | None | $6.17 | $7.59 | $9.55 |
Medcost Setting Professional Modifier None Typical Low $4.07 Median $11.75 Typical High $11.75 | Professional | None | $4.07 | $11.75 | $11.75 |
United Setting Professional Modifier None Typical Low $2.04 Median $7.41 Typical High $11.22 | Professional | None | $2.04 | $7.41 | $11.22 |
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 $0.85 Median $0.93 Typical High $0.93 | Professional | 55 · Aftercare only | $0.85 | $0.93 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.56 | $0.62 | $0.62 |
Where South Carolina sits
The same service costs 4.2 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· 6th of 51
$7.76
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.