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 $1.41 Median $1.41 Typical High $1.41 | Facility | None | $1.41 | $1.41 | $1.41 |
Aetna Setting Professional Modifier None Typical Low $1.15 Median $1.41 Typical High $1.55 | Professional | None | $1.15 | $1.41 | $1.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.58 Median $0.71 Typical High $0.78 | Professional | 52 · Reduced service | $0.58 | $0.71 | $0.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.24 Median $0.28 Typical High $0.31 | Professional | 53 · Discontinued | $0.24 | $0.28 | $0.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.21 Typical High $0.23 | Professional | 55 · Aftercare only | $0.17 | $0.21 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.14 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.12 | $0.14 | $0.15 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1.78 Median $1.82 Typical High $1.82 | Professional | None | $1.78 | $1.82 | $1.82 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Medcost Setting Facility Modifier None Typical Low $1.29 Median $1.41 Typical High $4.90 | Facility | None | $1.29 | $1.41 | $4.90 |
Medcost Setting Professional Modifier None Typical Low $1.35 Median $2.00 Typical High $2.34 | Professional | None | $1.35 | $2.00 | $2.34 |
United Setting Professional Modifier None Typical Low $0.63 Median $0.87 Typical High $1.15 | Professional | None | $0.63 | $0.87 | $1.15 |
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 $0.68 Median $1.00 Typical High $1.51 | Professional | 51 · Multiple procedures | $0.68 | $1.00 | $1.51 |
Where South Carolina sits
The same service costs 2.5 times more in Idaho 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
$1.78
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.