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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $45.71 | Professional | None | $37.15 | $37.15 | $45.71 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $44.67 | Professional | None | $40.74 | $44.67 | $44.67 |
BCBS South Carolina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 29 | $44.67 | $44.67 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $44.67 | Professional | None | $7.59 | $7.59 | $44.67 |
Medcost Setting Facility Modifier None Typical Low $37.15 Median $44.67 Typical High $50.12 | Facility | None | $37.15 | $44.67 | $50.12 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
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 $18.62 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $3.72 |
Where South Carolina sits
The same service costs 204.2 times more in Montana than in Kansas. 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· 22nd of 51
$37.15
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.