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 $6.46 Median $6.46 Typical High $8.32 | Facility | None | $6.46 | $6.46 | $8.32 |
Aetna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.76 | Professional | None | $6.46 | $6.46 | $6.76 |
BCBS South Carolina Setting Professional Modifier None Typical Low $6.92 Median $7.94 Typical High $7.94 | Professional | None | $6.92 | $7.94 | $7.94 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $12.88 Typical High $16.60 | Facility | None | $7.59 | $12.88 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Medcost Setting Facility Modifier None Typical Low $0.79 Median $7.08 Typical High $8.71 | Facility | None | $0.79 | $7.08 | $8.71 |
Medcost Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $6.76 | Professional | None | $4.17 | $4.17 | $6.76 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Professional Modifier None Typical Low $2.63 Median $6.61 Typical High $6.61 | Professional | None | $2.63 | $6.61 | $6.61 |
4 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 $3.24 Median $3.24 Typical High $3.39 | Professional | 52 · Reduced service | $3.24 | $3.24 | $3.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.29 Median $1.29 Typical High $1.35 | Professional | 53 · Discontinued | $1.29 | $1.29 | $1.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.98 Median $0.98 Typical High $1.00 | Professional | 55 · Aftercare only | $0.98 | $0.98 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $0.65 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.65 | $0.65 | $0.68 |
Where South Carolina sits
The same service costs 15.5 times more in Alaska than in Hawaii. 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· 2nd of 51
$6.92
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.