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 $34.67 Median $34.67 Typical High $46.77 | Facility | None | $34.67 | $34.67 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $34.67 Typical High $38.02 | Professional | None | $27.54 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $17.38 Typical High $19.05 | Professional | 52 · Reduced service | $14.13 | $17.38 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $6.92 Typical High $7.59 | Professional | 53 · Discontinued | $5.62 | $6.92 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $5.25 Typical High $5.62 | Professional | 55 · Aftercare only | $4.27 | $5.25 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.47 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.82 | $3.47 | $3.80 |
BCBS South Carolina Setting Professional Modifier None Typical Low $43.65 Median $44.67 Typical High $44.67 | Professional | None | $43.65 | $44.67 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Medcost Setting Facility Modifier None Typical Low $30.90 Median $34.67 Typical High $123.03 | Facility | None | $30.90 | $34.67 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $28.18 Median $33.88 Typical High $48.98 | Professional | None | $28.18 | $33.88 | $48.98 |
United Setting Professional Modifier None Typical Low $12.88 Median $15.14 Typical High $15.14 | Professional | None | $12.88 | $15.14 | $15.14 |
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 $16.22 Median $16.98 Typical High $37.15 | Professional | 51 · Multiple procedures | $16.22 | $16.98 | $37.15 |
Where South Carolina sits
The same service costs 3.2 times more in Hawaii than in Utah. 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· 5th of 51
$43.65
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.