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 $7.76 Median $7.76 Typical High $7.76 | Facility | None | $7.76 | $7.76 | $7.76 |
Aetna Setting Professional Modifier None Typical Low $6.17 Median $7.76 Typical High $7.76 | Professional | None | $6.17 | $7.76 | $7.76 |
BCBS Setting Facility Modifier None Typical Low $8.91 Median $10.00 Typical High $10.00 | Facility | None | $8.91 | $10.00 | $10.00 |
BCBS Setting Professional Modifier None Typical Low $6.03 Median $7.08 Typical High $10.00 | Professional | None | $6.03 | $7.08 | $10.00 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $6.31 | Facility | None | $5.89 | $5.89 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $6.31 | Professional | None | $5.01 | $5.01 | $6.31 |
Medcost Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $6.31 | Professional | None | $4.90 | $4.90 | $6.31 |
Medcost Setting Facility Modifier None Typical Low $2.69 Median $8.13 Typical High $12.02 | Facility | None | $2.69 | $8.13 | $12.02 |
Medcost Setting Professional Modifier None Typical Low $6.03 Median $7.41 Typical High $11.22 | Professional | None | $6.03 | $7.41 | $11.22 |
Molina Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | None | $6.61 | $6.61 | $6.61 |
United Setting Professional Modifier None Typical Low $3.24 Median $4.68 Typical High $6.03 | Professional | None | $3.24 | $4.68 | $6.03 |
4 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 $1.00 Median $1.17 Typical High $1.17 | Professional | 55 · Aftercare only | $1.00 | $1.17 | $1.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $0.78 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.68 | $0.78 | $0.78 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | KX · Policy requirements met | $4.57 | $4.57 | $4.57 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.02 Median $3.98 Typical High $8.71 | Professional | 51 · Multiple procedures | $3.02 | $3.98 | $8.71 |
Where South Carolina sits
The same service costs 2.4 times more in Kansas 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· 20th of 51
$7.08
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.