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 $2.19 Median $2.19 Typical High $2.19 | Facility | None | $2.19 | $2.19 | $2.19 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.19 Typical High $2.19 | Professional | None | $2.04 | $2.19 | $2.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2.51 Median $2.75 Typical High $2.75 | Professional | None | $2.51 | $2.75 | $2.75 |
Cigna Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.70 | Professional | None | $1.17 | $1.17 | $1.70 |
Medcost Setting Facility Modifier None Typical Low $2.19 Median $2.57 Typical High $2.95 | Facility | None | $2.19 | $2.57 | $2.95 |
Medcost Setting Professional Modifier None Typical Low $1.26 Median $3.55 Typical High $3.55 | Professional | None | $1.26 | $3.55 | $3.55 |
United Setting Professional Modifier None Typical Low $0.79 Median $2.29 Typical High $3.47 | Professional | None | $0.79 | $2.29 | $3.47 |
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 $0.30 Median $0.33 Typical High $0.33 | Professional | 55 · Aftercare only | $0.30 | $0.33 | $0.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.22 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.20 | $0.22 | $0.22 |
Where South Carolina sits
The same service costs 33.1 times more in Kansas 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
$2.51
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.