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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $33.88 | Professional | None | $32.36 | $33.88 | $33.88 |
BCBS South Carolina Setting Facility Modifier None Typical Low $26.30 Median $39.81 Typical High $70.79 | Facility | None | $26.30 | $39.81 | $70.79 |
BCBS South Carolina Setting Professional Modifier None Typical Low $32.36 Median $33.11 Typical High $36.31 | Professional | None | $32.36 | $33.11 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $52.48 Typical High $79.43 | Facility | None | $37.15 | $52.48 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Medcost Setting Facility Modifier None Typical Low $33.88 Median $38.02 Typical High $93.33 | Facility | None | $33.88 | $38.02 | $93.33 |
Medcost Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $38.02 | Professional | None | $25.70 | $25.70 | $38.02 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
United Setting Professional Modifier None Typical Low $26.30 Median $32.36 Typical High $32.36 | Professional | None | $26.30 | $32.36 | $32.36 |
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 $16.22 Median $16.98 Typical High $16.98 | Professional | 52 · Reduced service | $16.22 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.92 Typical High $6.92 | Professional | 53 · Discontinued | $6.46 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.13 Typical High $5.13 | Professional | 55 · Aftercare only | $4.90 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.39 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.24 | $3.39 | $3.39 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.88 Median $12.88 Typical High $23.44 | Professional | 51 · Multiple procedures | $12.88 | $12.88 | $23.44 |
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· 29th of 51
$32.36
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.