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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $107.15 Typical High $107.15 | Professional | None | $66.07 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $33.11 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $13.18 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $10.00 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.61 | $10.72 | $10.72 |
BCBS South Carolina Setting Professional Modifier None Typical Low $72.44 Median $204.17 Typical High $316.23 | Professional | None | $72.44 | $204.17 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Medcost Setting Facility Modifier None Typical Low $56.23 Median $107.15 Typical High $138.04 | Facility | None | $56.23 | $107.15 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | None | $54.95 | $54.95 | $61.66 |
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 $50.12 Median $61.66 Typical High $87.10 | Professional | None | $50.12 | $61.66 | $87.10 |
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 $27.54 Median $27.54 Typical High $38.90 | Professional | 51 · Multiple procedures | $27.54 | $27.54 | $38.90 |
Where South Carolina sits
The same service costs 3.0 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· 28th of 51
$63.10
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.