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 $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $39.81 Typical High $39.81 | Professional | None | $38.90 | $39.81 | $39.81 |
BCBS South Carolina Setting Facility Modifier None Typical Low $69.18 Median $123.03 Typical High $213.80 | Facility | None | $69.18 | $123.03 | $213.80 |
BCBS South Carolina Setting Professional Modifier None Typical Low $31.62 Median $38.02 Typical High $38.02 | Professional | None | $31.62 | $38.02 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $66.07 Typical High $93.33 | Facility | None | $53.70 | $66.07 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $39.81 Median $43.65 Typical High $134.90 | Facility | None | $39.81 | $43.65 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $48.98 Median $64.57 Typical High $309.03 | Professional | None | $48.98 | $64.57 | $309.03 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $95.50 Typical High $100.00 | Professional | None | $30.20 | $95.50 | $100.00 |
United Setting Professional Modifier None Typical Low $31.62 Median $40.74 Typical High $41.69 | Professional | None | $31.62 | $40.74 | $41.69 |
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 $19.05 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $19.05 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.76 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $5.75 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.89 | $3.98 | $3.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.20 Median $51.29 Typical High $229.09 | Professional | 51 · Multiple procedures | $30.20 | $51.29 | $229.09 |
Where South Carolina sits
The same service costs 1.6 times more in Alaska than in South 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· 51st of 51
$38.02
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.