How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $1.95 Median $1.95 Typical High $1.95 | Facility | None | $1.95 | $1.95 | $1.95 |
Aetna Setting Professional Modifier None Typical Low $1.86 Median $1.95 Typical High $1.95 | Professional | None | $1.86 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.93 Median $0.98 Typical High $0.98 | Professional | 52 · Reduced service | $0.93 | $0.98 | $0.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.37 Median $0.39 Typical High $0.39 | Professional | 53 · Discontinued | $0.37 | $0.39 | $0.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.20 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.19 | $0.20 | $0.20 |
BCBS South Carolina Setting Facility Modifier None Typical Low $0.91 Median $1.74 Typical High $3.16 | Facility | None | $0.91 | $1.74 | $3.16 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Cigna Setting Facility Modifier None Typical Low $2.09 Median $3.24 Typical High $4.57 | Facility | None | $2.09 | $3.24 | $4.57 |
Cigna Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Medcost Setting Facility Modifier None Typical Low $1.95 Median $2.14 Typical High $5.13 | Facility | None | $1.95 | $2.14 | $5.13 |
Medcost Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $2.14 | Professional | None | $1.12 | $1.12 | $2.14 |
Molina Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
United Setting Professional Modifier None Typical Low $1.48 Median $1.86 Typical High $1.86 | Professional | None | $1.48 | $1.86 | $1.86 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.56 Median $0.56 Typical High $1.23 | Professional | 51 · Multiple procedures | $0.56 | $0.56 | $1.23 |
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· 13th of 51
$1.86
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.