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 $2.09 Median $2.09 Typical High $2.09 | Facility | None | $2.09 | $2.09 | $2.09 |
Aetna Setting Professional Modifier None Typical Low $1.66 Median $2.09 Typical High $2.29 | Professional | None | $1.66 | $2.09 | $2.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.85 Median $1.05 Typical High $1.15 | Professional | 52 · Reduced service | $0.85 | $1.05 | $1.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.34 Median $0.42 Typical High $0.46 | Professional | 53 · Discontinued | $0.34 | $0.42 | $0.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.31 Typical High $0.34 | Professional | 55 · Aftercare only | $0.26 | $0.31 | $0.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.21 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.17 | $0.21 | $0.23 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2.63 Median $2.75 Typical High $2.75 | Professional | None | $2.63 | $2.75 | $2.75 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Medcost Setting Facility Modifier None Typical Low $1.86 Median $2.09 Typical High $7.41 | Facility | None | $1.86 | $2.09 | $7.41 |
Medcost Setting Professional Modifier None Typical Low $1.95 Median $2.00 Typical High $3.47 | Professional | None | $1.95 | $2.00 | $3.47 |
United Setting Professional Modifier None Typical Low $0.93 Median $1.32 Typical High $1.70 | Professional | None | $0.93 | $1.32 | $1.70 |
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 $0.98 Median $1.00 Typical High $2.24 | Professional | 51 · Multiple procedures | $0.98 | $1.00 | $2.24 |
Where South Carolina sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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
$2.63
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.