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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $61.66 | Professional | None | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $29.51 Typical High $30.90 | Professional | 52 · Reduced service | $29.51 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $12.30 | Professional | 53 · Discontinued | $11.75 | $11.75 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $9.33 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $6.17 |
BCBS Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $69.18 | Professional | None | $67.61 | $67.61 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $117.49 Typical High $151.36 | Facility | None | $69.18 | $117.49 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Medcost Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $97.72 | Professional | None | $47.86 | $47.86 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $58.88 Median $72.44 Typical High $83.18 | Facility | None | $58.88 | $72.44 | $83.18 |
Medcost Setting Professional Modifier None Typical Low $63.10 Median $72.44 Typical High $77.62 | Professional | None | $63.10 | $72.44 | $77.62 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $61.66 | Professional | None | $57.54 | $57.54 | $61.66 |
United Setting Professional Modifier None Typical Low $47.86 Median $60.26 Typical High $60.26 | Professional | None | $47.86 | $60.26 | $60.26 |
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 $31.62 Median $38.90 Typical High $39.81 | Professional | 51 · Multiple procedures | $31.62 | $38.90 | $39.81 |
Where South Carolina sits
The same service costs 1.6 times more in Alaska than in Hawaii. 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· 19th of 51
$61.66
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.