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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $43.65 | Professional | None | $36.31 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $18.20 Typical High $21.88 | Professional | 52 · Reduced service | $18.20 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $8.71 | Professional | 53 · Discontinued | $7.41 | $7.41 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $6.61 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $4.37 |
BCBS South Carolina Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Medcost Setting Facility Modifier None Typical Low $36.31 Median $43.65 Typical High $125.89 | Facility | None | $36.31 | $43.65 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $28.84 Median $29.51 Typical High $50.12 | Professional | None | $28.84 | $29.51 | $50.12 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $46.77 Typical High $64.57 | Professional | None | $32.36 | $46.77 | $64.57 |
United Setting Professional Modifier None Typical Low $38.02 Median $45.71 Typical High $69.18 | Professional | None | $38.02 | $45.71 | $69.18 |
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 $14.45 Median $14.79 Typical High $31.62 | Professional | 51 · Multiple procedures | $14.45 | $14.79 | $31.62 |
Where South Carolina sits
The same service costs 2.6 times more in North Dakota than in Ohio. 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· 15th of 51
$47.86
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.