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 $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $26.30 Typical High $26.30 | Professional | None | $25.12 | $26.30 | $26.30 |
Ambetter Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
BCBS South Carolina Setting Facility Modifier None Typical Low $35.48 Median $40.74 Typical High $44.67 | Facility | None | $35.48 | $40.74 | $44.67 |
BCBS South Carolina Setting Professional Modifier None Typical Low $25.12 Median $26.92 Typical High $30.90 | Professional | None | $25.12 | $26.92 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $43.65 Typical High $61.66 | Facility | None | $34.67 | $43.65 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $239.88 | Professional | None | $44.67 | $44.67 | $239.88 |
Medcost Setting Facility Modifier None Typical Low $25.12 Median $28.84 Typical High $70.79 | Facility | None | $25.12 | $28.84 | $70.79 |
Medcost Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $199.53 | Professional | None | $28.18 | $30.20 | $199.53 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $42.66 Typical High $64.57 | Professional | None | $30.20 | $42.66 | $64.57 |
United Setting Professional Modifier None Typical Low $13.18 Median $16.98 Typical High $17.78 | Professional | None | $13.18 | $16.98 | $17.78 |
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 $12.30 Median $13.18 Typical High $13.18 | Professional | 52 · Reduced service | $12.30 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.25 Typical High $5.25 | Professional | 53 · Discontinued | $5.01 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.72 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.63 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.45 | $2.63 | $2.63 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.13 Median $20.89 Typical High $173.78 | Professional | 51 · Multiple procedures | $14.13 | $20.89 | $173.78 |
Where South Carolina sits
The same service costs 1.9 times more in Wyoming than in Arizona. 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· 43rd of 51
$25.12
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.