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 $0.83 Median $0.83 Typical High $0.83 | Facility | None | $0.83 | $0.83 | $0.83 |
Aetna Setting Professional Modifier None Typical Low $0.81 Median $0.83 Typical High $0.85 | Professional | None | $0.81 | $0.83 | $0.85 |
BCBS South Carolina Setting Facility Modifier None Typical Low $0.91 Median $1.26 Typical High $2.40 | Facility | None | $0.91 | $1.26 | $2.40 |
BCBS South Carolina Setting Professional Modifier None Typical Low $0.79 Median $1.15 Typical High $1.20 | Professional | None | $0.79 | $1.15 | $1.20 |
Cigna Setting Facility Modifier None Typical Low $0.89 Median $1.41 Typical High $1.95 | Facility | None | $0.89 | $1.41 | $1.95 |
Cigna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Medcost Setting Facility Modifier None Typical Low $0.83 Median $1.00 Typical High $2.19 | Facility | None | $0.83 | $1.00 | $2.19 |
Medcost Setting Professional Modifier None Typical Low $0.98 Median $1.15 Typical High $1.32 | Professional | None | $0.98 | $1.15 | $1.32 |
Molina Setting Professional Modifier None Typical Low $1.82 Median $1.95 Typical High $1.95 | Professional | None | $1.82 | $1.95 | $1.95 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.83 Typical High $0.83 | Professional | None | $0.65 | $0.83 | $0.83 |
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 $0.41 Median $0.42 Typical High $0.42 | Professional | 52 · Reduced service | $0.41 | $0.42 | $0.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 53 · Discontinued | $0.17 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.13 Typical High $0.13 | Professional | 55 · Aftercare only | $0.12 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.58 Median $0.58 Typical High $0.62 | Professional | 51 · Multiple procedures | $0.58 | $0.58 | $0.62 |
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· 9th of 51
$0.83
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.