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 $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $15.85 Typical High $17.38 | Professional | None | $12.88 | $15.85 | $17.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $19.95 Median $20.89 Typical High $20.89 | Professional | None | $19.95 | $20.89 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Medcost Setting Facility Modifier None Typical Low $15.49 Median $15.85 Typical High $54.95 | Facility | None | $15.49 | $15.85 | $54.95 |
Medcost Setting Professional Modifier None Typical Low $15.85 Median $17.78 Typical High $28.18 | Professional | None | $15.85 | $17.78 | $28.18 |
United Setting Professional Modifier None Typical Low $6.92 Median $9.77 Typical High $12.30 | Professional | None | $6.92 | $9.77 | $12.30 |
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 $6.61 Median $7.94 Typical High $8.71 | Professional | 52 · Reduced service | $6.61 | $7.94 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $3.16 Typical High $3.47 | Professional | 53 · Discontinued | $2.63 | $3.16 | $3.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.00 Median $11.75 Typical High $12.88 | Professional | 54 · Surgery only | $10.00 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.34 Typical High $2.57 | Professional | 55 · Aftercare only | $2.00 | $2.34 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.58 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.32 | $1.58 | $1.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $7.76 Median $8.71 Typical High $16.98 | Professional | 51 · Multiple procedures | $7.76 | $8.71 | $16.98 |
Where South Carolina sits
The same service costs 2.8 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
$19.95
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.