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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $128.82 | Professional | None | $100.00 | $117.49 | $128.82 |
BCBS South Carolina Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $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 Facility Modifier None Typical Low $114.82 Median $117.49 Typical High $416.87 | Facility | None | $114.82 | $117.49 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $234.42 | Professional | None | $128.82 | $147.91 | $234.42 |
United Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $91.20 | Professional | None | $52.48 | $72.44 | $91.20 |
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 $50.12 Median $58.88 Typical High $64.57 | Professional | 52 · Reduced service | $50.12 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $23.44 Typical High $25.70 | Professional | 53 · Discontinued | $19.95 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $89.13 Typical High $97.72 | Professional | 54 · Surgery only | $74.13 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $17.78 Typical High $19.50 | Professional | 55 · Aftercare only | $14.79 | $17.78 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.75 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.00 | $11.75 | $12.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $64.57 Median $74.13 Typical High $125.89 | Professional | 51 · Multiple procedures | $64.57 | $74.13 | $125.89 |
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· 2nd of 51
$151
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.