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 $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
Aetna Setting Professional Modifier None Typical Low $3.16 Median $3.80 Typical High $4.17 | Professional | None | $3.16 | $3.80 | $4.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.58 Median $1.91 Typical High $2.09 | Professional | 52 · Reduced service | $1.58 | $1.91 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.63 Median $0.76 Typical High $0.83 | Professional | 53 · Discontinued | $0.63 | $0.76 | $0.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.47 Median $0.56 Typical High $0.63 | Professional | 55 · Aftercare only | $0.47 | $0.56 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.38 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.31 | $0.38 | $0.42 |
BCBS South Carolina Setting Professional Modifier None Typical Low $4.90 Median $15.85 Typical High $15.85 | Professional | None | $4.90 | $15.85 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Medcost Setting Facility Modifier None Typical Low $3.39 Median $3.80 Typical High $13.49 | Facility | None | $3.39 | $3.80 | $13.49 |
Medcost Setting Professional Modifier None Typical Low $3.55 Median $3.98 Typical High $6.31 | Professional | None | $3.55 | $3.98 | $6.31 |
United Setting Professional Modifier None Typical Low $1.70 Median $2.34 Typical High $3.02 | Professional | None | $1.70 | $2.34 | $3.02 |
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 $1.78 Median $2.00 Typical High $4.07 | Professional | 51 · Multiple procedures | $1.78 | $2.00 | $4.07 |
Where South Carolina sits
The same service costs 2.6 times more in Hawaii than in Maine. 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· 4th of 51
$4.90
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.