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 $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $35.48 Typical High $38.02 | Professional | None | $29.51 | $35.48 | $38.02 |
BCBS South Carolina Setting Professional Modifier None Typical Low $44.67 Median $45.71 Typical High $45.71 | Professional | None | $44.67 | $45.71 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Medcost Setting Facility Modifier None Typical Low $34.67 Median $35.48 Typical High $123.03 | Facility | None | $34.67 | $35.48 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $38.90 Median $44.67 Typical High $70.79 | Professional | None | $38.90 | $44.67 | $70.79 |
United Setting Professional Modifier None Typical Low $15.49 Median $21.88 Typical High $26.92 | Professional | None | $15.49 | $21.88 | $26.92 |
6 more rates 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $17.38 Typical High $19.05 | Professional | 52 · Reduced service | $14.79 | $17.38 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $7.08 Typical High $7.76 | Professional | 53 · Discontinued | $5.89 | $7.08 | $7.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $26.30 Typical High $28.84 | Professional | 54 · Surgery only | $22.39 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $5.25 Typical High $5.75 | Professional | 55 · Aftercare only | $4.47 | $5.25 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.55 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.95 | $3.55 | $3.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.50 Median $22.39 Typical High $38.02 | Professional | 51 · Multiple procedures | $19.50 | $22.39 | $38.02 |
Where South Carolina sits
The same service costs 2.7 times more in Hawaii than in New York. 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· 5th of 51
$44.67
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.