How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $8.51 Typical High $9.12 | Professional | None | $8.32 | $8.51 | $9.12 |
BCBS South Carolina Setting Facility Modifier None Typical Low $27.54 Median $40.74 Typical High $67.61 | Facility | None | $27.54 | $40.74 | $67.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $8.13 Median $26.30 Typical High $26.92 | Professional | None | $8.13 | $26.30 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $14.45 Typical High $19.95 | Facility | None | $11.48 | $14.45 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Medcost Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $72.44 | Professional | None | $38.02 | $38.02 | $72.44 |
Medcost Setting Facility Modifier None Typical Low $8.51 Median $26.30 Typical High $41.69 | Facility | None | $8.51 | $26.30 | $41.69 |
Medcost Setting Professional Modifier None Typical Low $23.99 Median $41.69 Typical High $67.61 | Professional | None | $23.99 | $41.69 | $67.61 |
Molina Setting Professional Modifier None Typical Low $18.62 Median $20.42 Typical High $30.20 | Professional | None | $18.62 | $20.42 | $30.20 |
United Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $17.78 | Facility | None | $8.13 | $8.13 | $17.78 |
United Setting Professional Modifier None Typical Low $6.92 Median $8.91 Typical High $9.33 | Professional | None | $6.92 | $8.91 | $9.33 |
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 $4.17 Median $4.27 Typical High $4.27 | Professional | 52 · Reduced service | $4.17 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $1.74 Typical High $1.74 | Professional | 53 · Discontinued | $1.66 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.29 Typical High $1.29 | Professional | 55 · Aftercare only | $1.23 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $0.85 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.83 | $0.85 | $0.85 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.02 Median $19.95 Typical High $33.88 | Professional | 51 · Multiple procedures | $12.02 | $19.95 | $33.88 |
Where South Carolina sits
The same service costs 1.9 times more in Wyoming than in Georgia. 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
$9.33
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.