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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | None | $56.23 | $60.26 | $60.26 |
BCBS South Carolina Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
BCBS South Carolina Setting Professional Modifier None Typical Low $30.90 Median $51.29 Typical High $56.23 | Professional | None | $30.90 | $51.29 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $100.00 Typical High $138.04 | Facility | None | $64.57 | $100.00 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Medcost Setting Facility Modifier None Typical Low $38.90 Median $64.57 Typical High $154.88 | Facility | None | $38.90 | $64.57 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $60.26 | Professional | None | $12.88 | $12.88 | $60.26 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $45.71 Typical High $46.77 | Professional | None | $42.66 | $45.71 | $46.77 |
United Setting Professional Modifier None Typical Low $21.88 Median $54.95 Typical High $54.95 | Professional | None | $21.88 | $54.95 | $54.95 |
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 $28.18 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $28.18 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $11.48 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.51 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.62 | $6.03 | $6.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.46 Median $6.46 Typical High $17.38 | Professional | 51 · Multiple procedures | $6.46 | $6.46 | $17.38 |
Where South Carolina sits
The same service costs 1.6 times more in Alaska than in Louisiana. 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· 14th of 51
$56.23
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.