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 $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $21.38 | Professional | None | $20.42 | $20.42 | $21.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $25.12 Median $147.91 Typical High $147.91 | Professional | None | $25.12 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $23.99 Median $40.74 Typical High $52.48 | Facility | None | $23.99 | $40.74 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Medcost Setting Facility Modifier None Typical Low $20.42 Median $22.39 Typical High $27.54 | Facility | None | $20.42 | $22.39 | $27.54 |
Medcost Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $25.12 | Professional | None | $23.99 | $23.99 | $25.12 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Professional Modifier None Typical Low $18.20 Median $21.38 Typical High $21.38 | Professional | None | $18.20 | $21.38 | $21.38 |
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 $10.23 Median $10.23 Typical High $10.72 | Professional | 52 · Reduced service | $10.23 | $10.23 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $4.27 | Professional | 53 · Discontinued | $4.07 | $4.07 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.09 Typical High $3.16 | Professional | 55 · Aftercare only | $3.09 | $3.09 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.14 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 51 · Multiple procedures | $11.75 | $11.75 | $11.75 |
Where South Carolina sits
The same service costs 1.7 times more in Alaska than in Hawaii. 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· 2nd of 51
$25.12
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.