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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $79.43 | Professional | None | $70.79 | $74.13 | $79.43 |
BCBS South Carolina Setting Facility Modifier None Typical Low $89.13 Median $128.82 Typical High $251.19 | Facility | None | $89.13 | $128.82 | $251.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $70.79 Median $107.15 Typical High $112.20 | Professional | None | $70.79 | $107.15 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $123.03 Typical High $173.78 | Facility | None | $100.00 | $123.03 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Medcost Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Medcost Setting Facility Modifier None Typical Low $74.13 Median $100.00 Typical High $223.87 | Facility | None | $74.13 | $100.00 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $64.57 Typical High $114.82 | Professional | None | $61.66 | $64.57 | $114.82 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $173.78 Typical High $181.97 | Professional | None | $30.20 | $173.78 | $181.97 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $151.36 | Facility | None | $70.79 | $70.79 | $151.36 |
United Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $77.62 | Professional | None | $58.88 | $77.62 | $77.62 |
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 $35.48 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $35.48 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $14.13 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.72 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.08 | $7.41 | $7.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.90 Median $32.36 Typical High $61.66 | Professional | 51 · Multiple procedures | $30.90 | $32.36 | $61.66 |
Where South Carolina sits
The same service costs 1.5 times more in Wyoming than in Florida. 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· 26th of 51
$74.13
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.