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 $3.24 Median $3.24 Typical High $4.90 | Facility | None | $3.24 | $3.24 | $4.90 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.31 | Professional | None | $3.24 | $3.24 | $3.31 |
Ambetter Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | None | $3.09 | $3.09 | $3.09 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1.12 Median $1.26 Typical High $16.22 | Facility | None | $1.12 | $1.26 | $16.22 |
BCBS South Carolina Setting Professional Modifier None Typical Low $3.09 Median $5.37 Typical High $5.37 | Professional | None | $3.09 | $5.37 | $5.37 |
Cigna Setting Facility Modifier None Typical Low $3.47 Median $5.37 Typical High $7.59 | Facility | None | $3.47 | $5.37 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.89 | Professional | None | $3.09 | $3.09 | $3.89 |
Medcost Setting Facility Modifier None Typical Low $3.24 Median $4.37 Typical High $7.08 | Facility | None | $3.24 | $4.37 | $7.08 |
Medcost Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $5.62 | Professional | None | $2.00 | $2.00 | $5.62 |
Molina Setting Professional Modifier None Typical Low $2.29 Median $2.63 Typical High $2.69 | Professional | None | $2.29 | $2.63 | $2.69 |
United Setting Professional Modifier None Typical Low $1.26 Median $3.16 Typical High $3.16 | Professional | None | $1.26 | $3.16 | $3.16 |
3 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 $0.48 Median $0.48 Typical High $0.49 | Professional | 55 · Aftercare only | $0.48 | $0.48 | $0.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.32 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.32 | $0.32 | $0.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.00 Median $1.00 Typical High $2.82 | Professional | 51 · Multiple procedures | $1.00 | $1.00 | $2.82 |
Where South Carolina sits
The same service costs 3.5 times more in Oklahoma than in 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· 11th of 51
$3.24
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.