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 $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $79.43 | Professional | None | $72.44 | $79.43 | $79.43 |
BCBS South Carolina Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | None | $0.09 | $0.09 | $0.09 |
Medcost Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $107.15 | Facility | None | $77.62 | $87.10 | $107.15 |
Medcost Setting Professional Modifier None Typical Low $33.11 Median $93.33 Typical High $93.33 | Professional | None | $33.11 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $28.84 Median $69.18 Typical High $85.11 | Professional | None | $28.84 | $69.18 | $85.11 |
2 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 55 · Aftercare only Typical Low $10.96 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $10.96 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.24 | $7.94 | $7.94 |
Where South Carolina sits
The same service costs 5.5 times more in Iowa than in Kansas. 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· 6th of 51
$85.11
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.