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 $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
Aetna Setting Professional Modifier None Typical Low $5.89 Median $6.76 Typical High $7.41 | Professional | None | $5.89 | $6.76 | $7.41 |
BCBS South Carolina Setting Professional Modifier None Typical Low $8.51 Median $8.91 Typical High $8.91 | Professional | None | $8.51 | $8.91 | $8.91 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Medcost Setting Facility Modifier None Typical Low $6.61 Median $6.76 Typical High $23.44 | Facility | None | $6.61 | $6.76 | $23.44 |
Medcost Setting Professional Modifier None Typical Low $9.55 Median $13.80 Typical High $24.55 | Professional | None | $9.55 | $13.80 | $24.55 |
United Setting Professional Modifier None Typical Low $2.95 Median $4.17 Typical High $5.25 | Professional | None | $2.95 | $4.17 | $5.25 |
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 $2.82 Median $3.39 Typical High $3.72 | Professional | 52 · Reduced service | $2.82 | $3.39 | $3.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.35 Typical High $1.48 | Professional | 53 · Discontinued | $1.12 | $1.35 | $1.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.27 Median $5.01 Typical High $5.50 | Professional | 54 · Surgery only | $4.27 | $5.01 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $1.00 Typical High $1.12 | Professional | 55 · Aftercare only | $0.85 | $1.00 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.68 Typical High $0.74 | Professional | 56 · Pre-op care only | $0.59 | $0.68 | $0.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.03 Median $7.08 Typical High $12.30 | Professional | 51 · Multiple procedures | $6.03 | $7.08 | $12.30 |
Where South Carolina sits
The same service costs 4.1 times more in Rhode Island 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· 6th of 51
$8.51
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.