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 $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $14.45 Typical High $14.45 | Professional | None | $14.13 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $7.24 Typical High $7.24 | Professional | 52 · Reduced service | $7.08 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.95 Typical High $2.95 | Professional | 53 · Discontinued | $2.82 | $2.95 | $2.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.19 Typical High $2.19 | Professional | 55 · Aftercare only | $2.14 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.45 |
Cigna Setting Facility Modifier None Typical Low $16.98 Median $28.84 Typical High $37.15 | Facility | None | $16.98 | $28.84 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Medcost Setting Facility Modifier None Typical Low $14.45 Median $16.22 Typical High $19.50 | Facility | None | $14.45 | $16.22 | $19.50 |
Medcost Setting Professional Modifier None Typical Low $3.24 Median $3.80 Typical High $4.68 | Professional | None | $3.24 | $3.80 | $4.68 |
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 $1.74 Median $1.95 Typical High $3.39 | Professional | None | $1.74 | $1.95 | $3.39 |
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 $1.62 Median $1.91 Typical High $2.29 | Professional | 51 · Multiple procedures | $1.62 | $1.91 | $2.29 |
Where South Carolina sits
The same service costs 4.8 times more in Maryland 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· 26th of 51
$14.45
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.