How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $10.00 Typical High $10.00 | Professional | None | $9.55 | $10.00 | $10.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $5.89 Median $6.61 Typical High $7.24 | Facility | None | $5.89 | $6.61 | $7.24 |
BCBS South Carolina Setting Professional Modifier None Typical Low $5.89 Median $6.31 Typical High $10.00 | Professional | None | $5.89 | $6.31 | $10.00 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $16.60 Typical High $23.44 | Facility | None | $13.49 | $16.60 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Medcost Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $47.86 | Professional | None | $7.76 | $7.76 | $47.86 |
Medcost Setting Facility Modifier None Typical Low $6.92 Median $10.96 Typical High $23.44 | Facility | None | $6.92 | $10.96 | $23.44 |
Medcost Setting Professional Modifier None Typical Low $4.79 Median $6.17 Typical High $38.02 | Professional | None | $4.79 | $6.17 | $38.02 |
Molina Setting Professional Modifier None Typical Low $20.89 Median $21.38 Typical High $30.20 | Professional | None | $20.89 | $21.38 | $30.20 |
United Setting Professional Modifier None Typical Low $6.46 Median $8.32 Typical High $8.51 | Professional | None | $6.46 | $8.32 | $8.51 |
6 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 $4.79 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $4.79 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $1.91 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.45 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.95 | $1.00 | $1.00 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | JZ · No drug discarded | $8.13 | $8.13 | $8.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.40 Median $3.72 Typical High $19.05 | Professional | 51 · Multiple procedures | $2.40 | $3.72 | $19.05 |
Where South Carolina sits
The same service costs 1.7 times more in Wyoming than in North 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· 44th of 51
$9.55
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.