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 $0.47 Median $0.47 Typical High $0.47 | Facility | None | $0.47 | $0.47 | $0.47 |
Aetna Setting Professional Modifier None Typical Low $0.44 Median $0.47 Typical High $0.47 | Professional | None | $0.44 | $0.47 | $0.47 |
BCBS South Carolina Setting Facility Modifier None Typical Low $0.30 Median $0.30 Typical High $0.30 | Facility | None | $0.30 | $0.30 | $0.30 |
BCBS South Carolina Setting Professional Modifier None Typical Low $0.44 Median $0.56 Typical High $1.10 | Professional | None | $0.44 | $0.56 | $1.10 |
Cigna Setting Facility Modifier None Typical Low $0.50 Median $0.78 Typical High $1.07 | Facility | None | $0.50 | $0.78 | $1.07 |
Cigna Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.54 | Professional | None | $0.44 | $0.44 | $0.54 |
Medcost Setting Facility Modifier None Typical Low $0.29 Median $0.52 Typical High $1.05 | Facility | None | $0.29 | $0.52 | $1.05 |
Medcost Setting Professional Modifier None Typical Low $0.47 Median $3.02 Typical High $3.55 | Professional | None | $0.47 | $3.02 | $3.55 |
Molina Setting Professional Modifier None Typical Low $0.33 Median $0.34 Typical High $0.38 | Professional | None | $0.33 | $0.34 | $0.38 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.44 Typical High $0.44 | Professional | None | $0.18 | $0.44 | $0.44 |
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 $0.23 Median $0.24 Typical High $0.24 | Professional | 52 · Reduced service | $0.23 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 53 · Discontinued | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.51 Median $1.51 Typical High $1.78 | Professional | 51 · Multiple procedures | $1.51 | $1.51 | $1.78 |
Where South Carolina sits
The same service costs 1.6 times more in Alaska than in Montana. 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· 12th of 51
$0.45
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.