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 $6.61 Median $6.61 Typical High $6.61 | Facility | None | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $6.61 Typical High $7.24 | Professional | None | $5.25 | $6.61 | $7.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.69 Median $3.31 Typical High $3.63 | Professional | 52 · Reduced service | $2.69 | $3.31 | $3.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.32 Typical High $1.45 | Professional | 53 · Discontinued | $1.07 | $1.32 | $1.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $1.00 Typical High $1.07 | Professional | 55 · Aftercare only | $0.81 | $1.00 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.66 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.54 | $0.66 | $0.72 |
BCBS South Carolina Setting Professional Modifier None Typical Low $8.32 Median $8.51 Typical High $8.51 | Professional | None | $8.32 | $8.51 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Medcost Setting Facility Modifier None Typical Low $5.89 Median $6.61 Typical High $23.44 | Facility | None | $5.89 | $6.61 | $23.44 |
Medcost Setting Professional Modifier None Typical Low $6.17 Median $7.08 Typical High $10.96 | Professional | None | $6.17 | $7.08 | $10.96 |
United Setting Professional Modifier None Typical Low $2.95 Median $4.07 Typical High $5.37 | Professional | None | $2.95 | $4.07 | $5.37 |
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 $3.09 Median $3.47 Typical High $7.08 | Professional | 51 · Multiple procedures | $3.09 | $3.47 | $7.08 |
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· 5th of 51
$8.32
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.