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 $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.37 | Professional | None | $4.27 | $4.27 | $4.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.09 Median $2.09 Typical High $2.19 | Professional | 52 · Reduced service | $2.09 | $2.09 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.83 Typical High $0.87 | Professional | 53 · Discontinued | $0.83 | $0.83 | $0.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.63 Median $0.63 Typical High $0.66 | Professional | 55 · Aftercare only | $0.63 | $0.63 | $0.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.42 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.42 | $0.42 | $0.44 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $5.13 | Facility | None | $3.89 | $3.89 | $5.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $21.88 Median $25.12 Typical High $25.12 | Professional | None | $21.88 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Medcost Setting Facility Modifier None Typical Low $4.27 Median $5.01 Typical High $69.18 | Facility | None | $4.27 | $5.01 | $69.18 |
Medcost Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $10.72 | Professional | None | $3.63 | $3.63 | $10.72 |
United Setting Professional Modifier None Typical Low $10.00 Median $12.88 Typical High $19.50 | Professional | None | $10.00 | $12.88 | $19.50 |
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 $1.82 Median $1.82 Typical High $18.20 | Professional | 51 · Multiple procedures | $1.82 | $1.82 | $18.20 |
Where South Carolina sits
The same service costs 6.9 times more in Montana than in Indiana. 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· 8th of 51
$21.88
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.