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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $123.03 Typical High $123.03 | Professional | None | $54.95 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $27.54 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $10.96 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $8.32 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $5.50 | $12.30 | $12.30 |
BCBS South Carolina Setting Professional Modifier None Typical Low $60.26 Median $234.42 Typical High $363.08 | Professional | None | $60.26 | $234.42 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Medcost Setting Facility Modifier None Typical Low $47.86 Median $123.03 Typical High $154.88 | Facility | None | $47.86 | $123.03 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $51.29 | Professional | None | $45.71 | $45.71 | $51.29 |
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 $41.69 Median $51.29 Typical High $72.44 | Professional | None | $41.69 | $51.29 | $72.44 |
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 $22.91 Median $22.91 Typical High $32.36 | Professional | 51 · Multiple procedures | $22.91 | $22.91 | $32.36 |
Where South Carolina sits
The same service costs 4.0 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· 27th of 51
$52.48
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.