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 $1.62 Median $8.51 Typical High $10.72 | Facility | None | $1.62 | $8.51 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.51 Typical High $8.51 | Professional | None | $8.13 | $8.51 | $8.51 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1.48 Median $6.03 Typical High $61.66 | Facility | None | $1.48 | $6.03 | $61.66 |
BCBS South Carolina Setting Professional Modifier None Typical Low $8.13 Median $10.47 Typical High $11.75 | Professional | None | $8.13 | $10.47 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $9.12 Median $14.13 Typical High $19.95 | Facility | None | $9.12 | $14.13 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Medcost Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $3.98 | Professional | None | $1.17 | $1.17 | $3.98 |
Medcost Setting Facility Modifier None Typical Low $2.57 Median $9.33 Typical High $11.75 | Facility | None | $2.57 | $9.33 | $11.75 |
Medcost Setting Professional Modifier None Typical Low $1.82 Median $3.31 Typical High $7.94 | Professional | None | $1.82 | $3.31 | $7.94 |
Molina Setting Professional Modifier None Typical Low $4.68 Median $7.41 Typical High $8.51 | Professional | None | $4.68 | $7.41 | $8.51 |
United Setting Professional Modifier None Typical Low $5.75 Median $7.24 Typical High $7.24 | Professional | None | $5.75 | $7.24 | $7.24 |
5 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 $4.07 Median $4.27 Typical High $4.27 | Professional | 52 · Reduced service | $4.07 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.70 Typical High $1.70 | Professional | 53 · Discontinued | $1.62 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.29 Typical High $1.29 | Professional | 55 · Aftercare only | $1.23 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.85 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.81 | $0.85 | $0.85 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.91 Median $2.04 Typical High $2.51 | Professional | 51 · Multiple procedures | $0.91 | $2.04 | $2.51 |
Where South Carolina sits
Rates are fairly even across states for this service. 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· 23rd of 51
$8.13
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.