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 $8.91 Median $8.91 Typical High $8.91 | Facility | None | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $9.33 | Professional | None | $8.91 | $8.91 | $9.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.47 Median $4.47 Typical High $4.68 | Professional | 52 · Reduced service | $4.47 | $4.47 | $4.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.82 Median $1.82 Typical High $1.86 | Professional | 53 · Discontinued | $1.82 | $1.82 | $1.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.35 Median $1.35 Typical High $1.41 | Professional | 55 · Aftercare only | $1.35 | $1.35 | $1.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $0.89 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.89 | $0.89 | $0.93 |
BCBS South Carolina Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
BCBS South Carolina Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $6.17 | Professional | None | $5.89 | $5.89 | $6.17 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $17.78 Typical High $22.91 | Facility | None | $13.18 | $17.78 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Medcost Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.55 | Professional | None | $3.31 | $3.31 | $3.55 |
Medcost Setting Facility Modifier None Typical Low $8.91 Median $10.47 Typical High $12.02 | Facility | None | $8.91 | $10.47 | $12.02 |
Medcost Setting Professional Modifier None Typical Low $3.02 Median $4.79 Typical High $9.33 | Professional | None | $3.02 | $4.79 | $9.33 |
Molina Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.47 | Professional | None | $10.00 | $10.00 | $10.47 |
United Setting Professional Modifier None Typical Low $7.41 Median $9.12 Typical High $9.12 | Professional | None | $7.41 | $9.12 | $9.12 |
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 $1.51 Median $2.40 Typical High $4.68 | Professional | 51 · Multiple procedures | $1.51 | $2.40 | $4.68 |
Where South Carolina sits
The same service costs 1.8 times more in Alaska than in Montana. 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· 43rd of 51
$9.12
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.