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 $0.62 Median $2.04 Typical High $4.47 | Facility | None | $0.62 | $2.04 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $0.93 Median $2.04 Typical High $2.04 | Professional | None | $0.93 | $2.04 | $2.04 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Facility | None | $1.00 | $1.00 | $1.00 |
BCBS South Carolina Setting Professional Modifier None Typical Low $0.39 Median $1.78 Typical High $1.95 | Professional | None | $0.39 | $1.78 | $1.95 |
Cigna Setting Facility Modifier None Typical Low $2.19 Median $3.39 Typical High $4.79 | Facility | None | $2.19 | $3.39 | $4.79 |
Cigna Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | None | $1.95 | $1.95 | $1.95 |
Medcost Setting Facility Modifier None Typical Low $0.59 Median $2.04 Typical High $4.47 | Facility | None | $0.59 | $2.04 | $4.47 |
Medcost Setting Professional Modifier None Typical Low $0.46 Median $0.46 Typical High $2.04 | Professional | None | $0.46 | $0.46 | $2.04 |
Molina Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | None | $1.45 | $1.45 | $1.45 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.91 Typical High $0.91 | Professional | None | $0.36 | $0.91 | $0.91 |
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 $0.14 Median $0.31 Typical High $0.31 | Professional | 55 · Aftercare only | $0.14 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.20 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.09 | $0.20 | $0.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.23 Median $0.23 Typical High $0.31 | Professional | 51 · Multiple procedures | $0.23 | $0.23 | $0.31 |
Where South Carolina sits
The same service costs 2.3 times more in Arkansas than in North Carolina. 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· 45th of 51
$1.38
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.