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 $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $34.67 Typical High $34.67 | Professional | None | $31.62 | $34.67 | $34.67 |
BCBS South Carolina Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $27.54 Median $28.84 Typical High $37.15 | Professional | None | $27.54 | $28.84 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Medcost Setting Facility Modifier None Typical Low $33.88 Median $38.02 Typical High $46.77 | Facility | None | $33.88 | $38.02 | $46.77 |
Medcost Setting Professional Modifier None Typical Low $14.45 Median $40.74 Typical High $40.74 | Professional | None | $14.45 | $40.74 | $40.74 |
United Setting Professional Modifier None Typical Low $12.59 Median $30.20 Typical High $37.15 | Professional | None | $12.59 | $30.20 | $37.15 |
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 $4.79 Median $5.13 Typical High $5.13 | Professional | 55 · Aftercare only | $4.79 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.16 | $3.47 | $3.47 |
Where South Carolina sits
The same service costs 3.5 times more in Montana than in New York. 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· 34th of 51
$28.84
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.