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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $81.28 Typical High $81.28 | Professional | None | $16.60 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.32 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $8.32 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $3.31 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $2.45 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $1.66 | $8.13 | $8.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $17.38 Median $154.88 Typical High $239.88 | Professional | None | $17.38 | $154.88 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Medcost Setting Facility Modifier None Typical Low $14.45 Median $81.28 Typical High $102.33 | Facility | None | $14.45 | $81.28 | $102.33 |
Medcost Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $15.49 | Professional | None | $13.80 | $13.80 | $15.49 |
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 $12.02 Median $15.14 Typical High $21.88 | Professional | None | $12.02 | $15.14 | $21.88 |
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 $6.92 Median $6.92 Typical High $9.77 | Professional | 51 · Multiple procedures | $6.92 | $6.92 | $9.77 |
Where South Carolina sits
The same service costs 4.9 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
$15.49
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.