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 $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $14.45 Typical High $14.45 | Professional | None | $13.49 | $14.45 | $14.45 |
BCBS South Carolina Setting Facility Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Facility | None | $15.49 | $15.49 | $15.49 |
BCBS South Carolina Setting Professional Modifier None Typical Low $15.49 Median $16.60 Typical High $18.20 | Professional | None | $15.49 | $16.60 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Medcost Setting Facility Modifier None Typical Low $14.45 Median $16.98 Typical High $19.95 | Facility | None | $14.45 | $16.98 | $19.95 |
Medcost Setting Professional Modifier None Typical Low $8.32 Median $23.44 Typical High $23.44 | Professional | None | $8.32 | $23.44 | $23.44 |
United Setting Professional Modifier None Typical Low $5.25 Median $14.79 Typical High $22.91 | Professional | None | $5.25 | $14.79 | $22.91 |
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 $2.00 Median $2.19 Typical High $2.19 | Professional | 55 · Aftercare only | $2.00 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.35 | $1.45 | $1.45 |
Where South Carolina sits
The same service costs 3.5 times more in Florida than in Alabama. 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· 8th of 51
$16.60
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.