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 $1.55 Median $1.55 Typical High $1.55 | Facility | None | $1.55 | $1.55 | $1.55 |
Aetna Setting Professional Modifier None Typical Low $1.29 Median $1.55 Typical High $1.70 | Professional | None | $1.29 | $1.55 | $1.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.65 Median $0.78 Typical High $0.85 | Professional | 52 · Reduced service | $0.65 | $0.78 | $0.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.31 Typical High $0.34 | Professional | 53 · Discontinued | $0.26 | $0.31 | $0.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.23 Typical High $0.26 | Professional | 55 · Aftercare only | $0.20 | $0.23 | $0.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.16 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.13 | $0.16 | $0.17 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2.00 Median $2.04 Typical High $2.04 | Professional | None | $2.00 | $2.04 | $2.04 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Medcost Setting Facility Modifier None Typical Low $1.38 Median $1.55 Typical High $5.50 | Facility | None | $1.38 | $1.55 | $5.50 |
Medcost Setting Professional Modifier None Typical Low $1.45 Median $2.00 Typical High $2.57 | Professional | None | $1.45 | $2.00 | $2.57 |
United Setting Professional Modifier None Typical Low $0.69 Median $0.98 Typical High $1.26 | Professional | None | $0.69 | $0.98 | $1.26 |
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 $0.72 Median $1.00 Typical High $1.66 | Professional | 51 · Multiple procedures | $0.72 | $1.00 | $1.66 |
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
$2.00
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.