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 $0.62 Median $0.62 Typical High $0.62 | Facility | None | $0.62 | $0.62 | $0.62 |
Aetna Setting Professional Modifier None Typical Low $0.49 Median $0.62 Typical High $0.68 | Professional | None | $0.49 | $0.62 | $0.68 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.26 Median $0.31 Typical High $0.34 | Professional | 52 · Reduced service | $0.26 | $0.31 | $0.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.12 Typical High $0.14 | Professional | 53 · Discontinued | $0.11 | $0.12 | $0.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.09 Typical High $0.10 | Professional | 55 · Aftercare only | $0.08 | $0.09 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.07 |
BCBS South Carolina Setting Professional Modifier None Typical Low $0.79 Median $0.81 Typical High $0.81 | Professional | None | $0.79 | $0.81 | $0.81 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Medcost Setting Facility Modifier None Typical Low $0.56 Median $0.62 Typical High $2.19 | Facility | None | $0.56 | $0.62 | $2.19 |
Medcost Setting Professional Modifier None Typical Low $0.59 Median $0.89 Typical High $1.05 | Professional | None | $0.59 | $0.89 | $1.05 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.39 Typical High $0.50 | Professional | None | $0.28 | $0.39 | $0.50 |
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 $0.30 Median $0.50 Typical High $0.68 | Professional | 51 · Multiple procedures | $0.30 | $0.50 | $0.68 |
Where South Carolina sits
The same service costs 2.6 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· 4th of 51
$0.79
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.