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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
BCBS South Carolina Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $114.82 | Professional | None | $102.33 | $102.33 | $114.82 |
Medcost Setting Facility Modifier None Typical Low $39.81 Median $104.71 Typical High $151.36 | Facility | None | $39.81 | $104.71 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $125.89 | Professional | None | $100.00 | $125.89 | $125.89 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $109.65 | Professional | None | $83.18 | $97.72 | $109.65 |
United Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $162.18 | Professional | None | $85.11 | $109.65 | $162.18 |
4 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 52 · Reduced service Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $10.47 |
Where South Carolina sits
The same service costs 3.0 times more in Alaska than in West Virginia. 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· 40th of 51
$105
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.