How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $0.83 Median $0.83 Typical High $0.83 | Facility | None | $0.83 | $0.83 | $0.83 |
Aetna Setting Professional Modifier None Typical Low $0.83 Median $0.83 Typical High $0.87 | Professional | None | $0.83 | $0.83 | $0.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.42 Median $0.42 Typical High $0.44 | Professional | 52 · Reduced service | $0.42 | $0.42 | $0.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 53 · Discontinued | $0.17 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 55 · Aftercare only | $0.13 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.09 |
BCBS South Carolina Setting Facility Modifier None Typical Low $141.25 Median $263.03 Typical High $457.09 | Facility | None | $141.25 | $263.03 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Medcost Setting Facility Modifier None Typical Low $0.83 Median $0.91 Typical High $1.12 | Facility | None | $0.83 | $0.91 | $1.12 |
Medcost Setting Professional Modifier None Typical Low $0.98 Median $0.98 Typical High $1.02 | Professional | None | $0.98 | $0.98 | $1.02 |
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 Facility Modifier None Typical Low $229.09 Median $281.84 Typical High $363.08 | Facility | None | $229.09 | $281.84 | $363.08 |
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 $0.48 Median $0.48 Typical High $0.48 | Professional | 51 · Multiple procedures | $0.48 | $0.48 | $0.48 |
Where South Carolina sits
The same service costs 173.8 times more in Missouri than in Illinois. 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· 31st of 51
$0.87
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.