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 $75.86 Median $75.86 Typical High $95.50 | Facility | None | $75.86 | $75.86 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $93.33 | Professional | None | $75.86 | $75.86 | $93.33 |
BCBS South Carolina Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $158.49 Typical High $204.17 | Facility | None | $93.33 | $158.49 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Medcost Setting Facility Modifier None Typical Low $75.86 Median $91.20 Typical High $144.54 | Facility | None | $75.86 | $91.20 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $851.14 | Professional | None | $95.50 | $138.04 | $851.14 |
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 $24.55 Median $53.70 Typical High $77.62 | Professional | None | $24.55 | $53.70 | $77.62 |
4 more rates 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $38.02 Typical High $46.77 | Professional | 52 · Reduced service | $38.02 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $18.62 | Professional | 53 · Discontinued | $15.14 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $14.13 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $9.33 |
Where South Carolina sits
The same service costs 5.0 times more in Ohio 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· 27th of 51
$83.18
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.