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 $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $380.19 | Professional | None | $338.84 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $169.82 Typical High $190.55 | Professional | 52 · Reduced service | $169.82 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $75.86 | Professional | 53 · Discontinued | $67.61 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $57.54 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $38.02 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $38.02 |
BCBS South Carolina Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $42.66 | Professional | None | $36.31 | $36.31 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Medcost Setting Facility Modifier None Typical Low $338.84 Median $407.38 Typical High $645.65 | Facility | None | $338.84 | $407.38 | $645.65 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $616.60 | Professional | None | $426.58 | $467.74 | $616.60 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $446.68 | Professional | None | $234.42 | $257.04 | $446.68 |
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 $213.80 Median $229.09 Typical High $309.03 | Professional | 51 · Multiple procedures | $213.80 | $229.09 | $309.03 |
Where South Carolina sits
The same service costs 17.0 times more in Iowa than in Kentucky. 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
$324
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.