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 $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $18.62 Typical High $20.42 | Professional | None | $14.79 | $18.62 | $20.42 |
Ambetter Setting Professional Modifier None Typical Low $29.51 Median $30.20 Typical High $34.67 | Professional | None | $29.51 | $30.20 | $34.67 |
BCBS South Carolina Setting Professional Modifier None Typical Low $23.99 Median $25.12 Typical High $25.12 | Professional | None | $23.99 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Medcost Setting Facility Modifier None Typical Low $18.20 Median $18.62 Typical High $66.07 | Facility | None | $18.20 | $18.62 | $66.07 |
Medcost Setting Professional Modifier None Typical Low $9.33 Median $26.92 Typical High $48.98 | Professional | None | $9.33 | $26.92 | $48.98 |
United Setting Professional Modifier None Typical Low $8.32 Median $11.48 Typical High $14.45 | Professional | None | $8.32 | $11.48 | $14.45 |
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 $7.94 Median $9.33 Typical High $10.23 | Professional | 52 · Reduced service | $7.94 | $9.33 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.72 Typical High $4.07 | Professional | 53 · Discontinued | $3.16 | $3.72 | $4.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.75 Median $14.13 Typical High $15.14 | Professional | 54 · Surgery only | $11.75 | $14.13 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $2.82 Typical High $3.09 | Professional | 55 · Aftercare only | $2.34 | $2.82 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.86 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.58 | $1.86 | $2.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $4.68 Median $15.14 Typical High $23.99 | Professional | 51 · Multiple procedures | $4.68 | $15.14 | $23.99 |
Where South Carolina sits
The same service costs 2.9 times more in Rhode Island than in New York. 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· 5th of 51
$23.99
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.