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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $40.74 Typical High $40.74 | Professional | None | $26.92 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.49 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $13.49 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $5.37 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $3.98 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.69 | $4.07 | $4.07 |
BCBS South Carolina Setting Professional Modifier None Typical Low $30.20 Median $77.62 Typical High $120.23 | Professional | None | $30.20 | $77.62 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Medcost Setting Facility Modifier None Typical Low $23.44 Median $40.74 Typical High $51.29 | Facility | None | $23.44 | $40.74 | $51.29 |
Medcost Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $25.70 | Professional | None | $22.91 | $22.91 | $25.70 |
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 $20.89 Median $25.70 Typical High $36.31 | Professional | None | $20.89 | $25.70 | $36.31 |
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 $11.22 Median $11.22 Typical High $15.85 | Professional | 51 · Multiple procedures | $11.22 | $11.22 | $15.85 |
Where South Carolina sits
The same service costs 2.7 times more in Alaska than in Connecticut. 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· 28th of 51
$25.70
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.