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 $0.26 Median $0.26 Typical High $0.26 | Facility | None | $0.26 | $0.26 | $0.26 |
Aetna Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.32 | Professional | None | $0.26 | $0.26 | $0.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.04 Typical High $0.05 | Professional | 55 · Aftercare only | $0.04 | $0.04 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Ambetter Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
Medcost Setting Facility Modifier None Typical Low $0.26 Median $0.31 Typical High $0.35 | Facility | None | $0.26 | $0.31 | $0.35 |
Medcost Setting Professional Modifier None Typical Low $0.33 Median $0.37 Typical High $0.52 | Professional | None | $0.33 | $0.37 | $0.52 |
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 $0.18 Median $0.20 Typical High $0.31 | Professional | None | $0.18 | $0.20 | $0.31 |
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 $0.16 Median $0.23 Typical High $0.49 | Professional | 51 · Multiple procedures | $0.16 | $0.23 | $0.49 |
Where South Carolina sits
The same service costs 15.5 times more in Minnesota than in Hawaii. 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
$0.26
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.