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 $1.55 Median $1.55 Typical High $1.55 | Facility | None | $1.55 | $1.55 | $1.55 |
Aetna Setting Professional Modifier None Typical Low $1.55 Median $1.55 Typical High $1.91 | Professional | None | $1.55 | $1.55 | $1.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.23 Typical High $0.28 | Professional | 55 · Aftercare only | $0.23 | $0.23 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.19 |
Cigna Setting Professional Modifier None Typical Low $0.87 Median $1.70 Typical High $1.70 | Professional | None | $0.87 | $1.70 | $1.70 |
Medcost Setting Facility Modifier None Typical Low $1.55 Median $1.86 Typical High $3.02 | Facility | None | $1.55 | $1.86 | $3.02 |
Medcost Setting Professional Modifier None Typical Low $1.95 Median $2.14 Typical High $2.88 | Professional | None | $1.95 | $2.14 | $2.88 |
Molina Setting Professional Modifier None Typical Low $5.75 Median $30.20 Typical High $30.20 | Professional | None | $5.75 | $30.20 | $30.20 |
United Setting Professional Modifier None Typical Low $1.07 Median $1.17 Typical High $2.14 | Professional | None | $1.07 | $1.17 | $2.14 |
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 $0.98 Median $1.07 Typical High $1.74 | Professional | 51 · Multiple procedures | $0.98 | $1.07 | $1.74 |
Where South Carolina sits
The same service costs 6.6 times more in Kentucky than in West Virginia. 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· 36th of 51
$1.55
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.