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 $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $5.50 Typical High $5.50 | Professional | None | $4.47 | $5.50 | $5.50 |
BCBS Setting Facility Modifier None Typical Low $6.31 Median $7.08 Typical High $7.08 | Facility | None | $6.31 | $7.08 | $7.08 |
BCBS Setting Professional Modifier None Typical Low $4.27 Median $5.01 Typical High $7.08 | Professional | None | $4.27 | $5.01 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $3.16 Median $4.17 Typical High $4.47 | Facility | None | $3.16 | $4.17 | $4.47 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.47 | Professional | None | $3.55 | $3.55 | $4.47 |
Medcost Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $4.47 | Professional | None | $3.47 | $3.47 | $4.47 |
Medcost Setting Facility Modifier None Typical Low $1.91 Median $5.75 Typical High $8.51 | Facility | None | $1.91 | $5.75 | $8.51 |
Medcost Setting Professional Modifier None Typical Low $3.98 Median $5.75 Typical High $9.12 | Professional | None | $3.98 | $5.75 | $9.12 |
Molina Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
United Setting Professional Modifier None Typical Low $2.29 Median $3.31 Typical High $4.17 | Professional | None | $2.29 | $3.31 | $4.17 |
3 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 55 · Aftercare only Typical Low $0.71 Median $0.81 Typical High $0.81 | Professional | 55 · Aftercare only | $0.71 | $0.81 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.48 Median $0.55 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.48 | $0.55 | $0.55 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.00 Median $2.88 Typical High $6.03 | Professional | 51 · Multiple procedures | $2.00 | $2.88 | $6.03 |
Where South Carolina sits
The same service costs 2.1 times more in Idaho than in Connecticut. 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· 18th of 51
$5.01
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.