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 $93.33 Median $93.33 Typical High $151.36 | Facility | None | $93.33 | $93.33 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $93.33 Typical High $93.33 | Professional | None | $91.20 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $45.71 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $13.80 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $9.12 | $9.33 | $9.33 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $89.13 | Professional | None | $75.86 | $89.13 | $89.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $97.72 | Professional | None | $93.33 | $93.33 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $102.33 Typical High $125.89 | Facility | None | $93.33 | $102.33 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $112.20 | Professional | None | $93.33 | $93.33 | $112.20 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $95.50 | Professional | None | $30.20 | $30.20 | $95.50 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $107.15 | Facility | None | $97.72 | $97.72 | $107.15 |
United Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $120.23 | Professional | None | $74.13 | $89.13 | $120.23 |
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 |
|---|---|---|---|---|---|
BCBS South Carolina Setting Professional Modifier 29 Typical Low $120.23 Median $134.90 Typical High $173.78 | Professional | 29 | $120.23 | $134.90 | $173.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $46.77 Median $46.77 Typical High $69.18 | Professional | 51 · Multiple procedures | $46.77 | $46.77 | $69.18 |
Where South Carolina sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 29th of 51
$93.33
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.