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 $28.18 Median $35.48 Typical High $35.48 | Facility | None | $28.18 | $35.48 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $35.48 Typical High $35.48 | Professional | None | $33.88 | $35.48 | $35.48 |
BCBS South Carolina Setting Facility Modifier None Typical Low $38.90 Median $57.54 Typical High $125.89 | Facility | None | $38.90 | $57.54 | $125.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $28.84 Median $33.88 Typical High $102.33 | Professional | None | $28.84 | $33.88 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $58.88 Typical High $83.18 | Facility | None | $47.86 | $58.88 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Medcost Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $89.13 | Professional | None | $19.50 | $19.50 | $89.13 |
Medcost Setting Facility Modifier None Typical Low $29.51 Median $47.86 Typical High $181.97 | Facility | None | $29.51 | $47.86 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $16.98 Median $67.61 Typical High $186.21 | Professional | None | $16.98 | $67.61 | $186.21 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $64.57 Typical High $85.11 | Professional | None | $30.20 | $64.57 | $85.11 |
United Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $74.13 | Facility | None | $33.88 | $33.88 | $74.13 |
United Setting Professional Modifier None Typical Low $22.91 Median $28.84 Typical High $30.20 | Professional | None | $22.91 | $28.84 | $30.20 |
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 $16.98 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $16.98 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $6.76 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $5.13 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.55 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.39 | $3.55 | $3.55 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $8.51 Median $33.88 Typical High $75.86 | Professional | 51 · Multiple procedures | $8.51 | $33.88 | $75.86 |
Where South Carolina sits
The same service costs 5.4 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· 32nd of 51
$33.88
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.