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 $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $19.50 Typical High $23.44 | Professional | None | $18.62 | $19.50 | $23.44 |
BCBS South Carolina Setting Facility Modifier None Typical Low $56.23 Median $72.44 Typical High $138.04 | Facility | None | $56.23 | $72.44 | $138.04 |
BCBS South Carolina Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $72.44 | Professional | None | $18.62 | $18.62 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $20.42 Median $32.36 Typical High $45.71 | Facility | None | $20.42 | $32.36 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Medcost Setting Facility Modifier None Typical Low $19.50 Median $26.30 Typical High $112.20 | Facility | None | $19.50 | $26.30 | $112.20 |
Medcost Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $85.11 | Professional | None | $60.26 | $60.26 | $85.11 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $42.66 Typical High $48.98 | Professional | None | $30.20 | $42.66 | $48.98 |
United Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $39.81 | Facility | None | $18.62 | $18.62 | $39.81 |
United Setting Professional Modifier None Typical Low $16.22 Median $20.89 Typical High $21.38 | Professional | None | $16.22 | $20.89 | $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 $9.33 Median $9.77 Typical High $9.77 | Professional | 52 · Reduced service | $9.33 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.89 Typical High $3.89 | Professional | 53 · Discontinued | $3.72 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.95 Typical High $2.95 | Professional | 55 · Aftercare only | $2.82 | $2.95 | $2.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.95 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.86 | $1.95 | $1.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.20 Median $30.20 Typical High $37.15 | Professional | 51 · Multiple procedures | $30.20 | $30.20 | $37.15 |
Where South Carolina sits
The same service costs 1.8 times more in Hawaii than in Ohio. 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· 30th of 51
$19.50
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.