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 $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $11.48 Typical High $11.48 | Professional | None | $10.47 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.25 Median $5.75 Typical High $5.75 | Professional | 52 · Reduced service | $5.25 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $2.29 Typical High $2.29 | Professional | 53 · Discontinued | $2.09 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.74 Typical High $1.74 | Professional | 55 · Aftercare only | $1.58 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.15 Typical High $1.15 | Professional | 56 · Pre-op care only | $1.05 | $1.15 | $1.15 |
BCBS Setting Facility Modifier None Typical Low $102.33 Median $190.55 Typical High $323.59 | Facility | None | $102.33 | $190.55 | $323.59 |
BCBS Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $16.22 Typical High $16.22 | Professional | None | $12.30 | $16.22 | $16.22 |
Medcost Setting Facility Modifier None Typical Low $11.48 Median $13.18 Typical High $31.62 | Facility | None | $11.48 | $13.18 | $31.62 |
Medcost Setting Professional Modifier None Typical Low $12.30 Median $22.91 Typical High $25.12 | Professional | None | $12.30 | $22.91 | $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 Facility Modifier None Typical Low $245.47 Median $302.00 Typical High $389.05 | Facility | None | $245.47 | $302.00 | $389.05 |
United Setting Professional Modifier None Typical Low $8.13 Median $10.72 Typical High $15.49 | Professional | None | $8.13 | $10.72 | $15.49 |
1 more rate 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.17 Median $11.48 Typical High $12.59 | Professional | 51 · Multiple procedures | $6.17 | $11.48 | $12.59 |
Where South Carolina sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 12th of 51
$15.14
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.