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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $38.02 Typical High $38.02 | Professional | None | $37.15 | $38.02 | $38.02 |
BCBS South Carolina Setting Facility Modifier None Typical Low $43.65 Median $66.07 Typical High $123.03 | Facility | None | $43.65 | $66.07 | $123.03 |
BCBS South Carolina Setting Professional Modifier None Typical Low $36.31 Median $50.12 Typical High $53.70 | Professional | None | $36.31 | $50.12 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $63.10 Typical High $89.13 | Facility | None | $51.29 | $63.10 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Medcost Setting Facility Modifier None Typical Low $38.02 Median $51.29 Typical High $107.15 | Facility | None | $38.02 | $51.29 | $107.15 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $46.77 Typical High $56.23 | Professional | None | $44.67 | $46.77 | $56.23 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $91.20 Typical High $91.20 | Professional | None | $30.20 | $91.20 | $91.20 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $77.62 | Facility | None | $36.31 | $36.31 | $77.62 |
United Setting Professional Modifier None Typical Low $28.84 Median $37.15 Typical High $38.90 | Professional | None | $28.84 | $37.15 | $38.90 |
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 $18.20 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $18.20 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $7.41 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.75 Typical High $5.75 | Professional | 55 · Aftercare only | $5.50 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.72 | $3.80 | $3.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $23.44 Median $23.44 Typical High $28.18 | Professional | 51 · Multiple procedures | $23.44 | $23.44 | $28.18 |
Where South Carolina sits
Rates are fairly even across states for this service. 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· 15th 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.