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 $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $10.96 Typical High $10.96 | Professional | None | $10.23 | $10.96 | $10.96 |
BCBS South Carolina Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
BCBS South Carolina Setting Professional Modifier None Typical Low $8.71 Median $9.33 Typical High $11.75 | Professional | None | $8.71 | $9.33 | $11.75 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Medcost Setting Facility Modifier None Typical Low $10.72 Median $12.02 Typical High $14.79 | Facility | None | $10.72 | $12.02 | $14.79 |
Medcost Setting Professional Modifier None Typical Low $4.57 Median $13.18 Typical High $13.18 | Professional | None | $4.57 | $13.18 | $13.18 |
United Setting Professional Modifier None Typical Low $3.98 Median $9.55 Typical High $11.75 | Professional | None | $3.98 | $9.55 | $11.75 |
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 $1.51 Median $1.66 Typical High $1.66 | Professional | 55 · Aftercare only | $1.51 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $1.02 | $1.12 | $1.12 |
Where South Carolina sits
The same service costs 4.6 times more in Florida than in New York. 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· 32nd of 51
$9.33
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.