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 $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $30.20 Typical High $30.20 | Professional | None | $28.84 | $30.20 | $30.20 |
BCBS South Carolina Setting Facility Modifier None Typical Low $23.44 Median $42.66 Typical High $85.11 | Facility | None | $23.44 | $42.66 | $85.11 |
BCBS South Carolina Setting Professional Modifier None Typical Low $28.84 Median $56.23 Typical High $64.57 | Professional | None | $28.84 | $56.23 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $50.12 Typical High $70.79 | Facility | None | $40.74 | $50.12 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Medcost Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $104.71 | Professional | None | $23.99 | $23.99 | $104.71 |
Medcost Setting Facility Modifier None Typical Low $30.20 Median $40.74 Typical High $81.28 | Facility | None | $30.20 | $40.74 | $81.28 |
Medcost Setting Professional Modifier None Typical Low $16.98 Median $50.12 Typical High $100.00 | Professional | None | $16.98 | $50.12 | $100.00 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $61.66 Typical High $72.44 | Professional | None | $30.20 | $61.66 | $72.44 |
United Setting Professional Modifier None Typical Low $19.95 Median $25.70 Typical High $26.30 | Professional | None | $19.95 | $25.70 | $26.30 |
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 $14.45 Median $15.14 Typical High $15.14 | Professional | 52 · Reduced service | $14.45 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.03 Typical High $6.03 | Professional | 53 · Discontinued | $5.75 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $4.37 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.88 | $3.02 | $3.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $8.51 Median $30.90 Typical High $48.98 | Professional | 51 · Multiple procedures | $8.51 | $30.90 | $48.98 |
Where South Carolina sits
The same service costs 2.8 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· 8th of 51
$30.20
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.