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 $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $19.05 Typical High $20.89 | Professional | None | $15.85 | $19.05 | $20.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $23.99 Median $25.12 Typical High $25.12 | Professional | None | $23.99 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Medcost Setting Facility Modifier None Typical Low $18.62 Median $19.05 Typical High $66.07 | Facility | None | $18.62 | $19.05 | $66.07 |
Medcost Setting Professional Modifier None Typical Low $26.92 Median $31.62 Typical High $54.95 | Professional | None | $26.92 | $31.62 | $54.95 |
United Setting Professional Modifier None Typical Low $8.32 Median $11.75 Typical High $14.45 | Professional | None | $8.32 | $11.75 | $14.45 |
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 $7.94 Median $9.33 Typical High $10.23 | Professional | 52 · Reduced service | $7.94 | $9.33 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.80 Typical High $4.17 | Professional | 53 · Discontinued | $3.16 | $3.80 | $4.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.02 Median $14.13 Typical High $15.49 | Professional | 54 · Surgery only | $12.02 | $14.13 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.82 Typical High $3.09 | Professional | 55 · Aftercare only | $2.40 | $2.82 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.91 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.58 | $1.91 | $2.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.14 Median $16.98 Typical High $27.54 | Professional | 51 · Multiple procedures | $15.14 | $16.98 | $27.54 |
Where South Carolina sits
The same service costs 3.2 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
$23.99
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.