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 $95.50 Median $5,623.41 Typical High $21,877.62 | Facility | None | $95.50 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $95.50 Typical High $95.50 | Professional | None | $77.62 | $95.50 | $95.50 |
BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
BCBS Setting Professional Modifier None Typical Low $69.18 Median $138.04 Typical High $204.17 | Professional | None | $69.18 | $138.04 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $186.21 | Professional | None | $87.10 | $114.82 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $104.71 Typical High $138.04 | Facility | None | $93.33 | $104.71 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $218.78 | Professional | None | $91.20 | $123.03 | $218.78 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $131.83 | Professional | None | $67.61 | $102.33 | $131.83 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $181.97 | Professional | None | $77.62 | $107.15 | $181.97 |
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 $38.90 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $38.90 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $15.49 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $70.79 Typical High $70.79 | Professional | 54 · Surgery only | $58.88 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $11.75 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.76 | $9.55 | $9.55 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $51.29 Median $74.13 Typical High $109.65 | Professional | 51 · Multiple procedures | $51.29 | $74.13 | $109.65 |
Where South Carolina sits
The same service costs 6.5 times more in Tennessee 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· 25th of 51
$135
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.