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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $58.88 Typical High $64.57 | Professional | None | $50.12 | $58.88 | $64.57 |
BCBS South Carolina Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Medcost Setting Facility Modifier None Typical Low $57.54 Median $58.88 Typical High $208.93 | Facility | None | $57.54 | $58.88 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $74.13 Typical High $117.49 | Professional | None | $64.57 | $74.13 | $117.49 |
United Setting Professional Modifier None Typical Low $26.30 Median $36.31 Typical High $45.71 | Professional | None | $26.30 | $36.31 | $45.71 |
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 $25.12 Median $29.51 Typical High $32.36 | Professional | 52 · Reduced service | $25.12 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $11.75 Typical High $12.88 | Professional | 53 · Discontinued | $10.00 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $44.67 Typical High $48.98 | Professional | 54 · Surgery only | $37.15 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.91 Typical High $9.77 | Professional | 55 · Aftercare only | $7.41 | $8.91 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.89 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.01 | $5.89 | $6.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $32.36 Median $37.15 Typical High $63.10 | Professional | 51 · Multiple procedures | $32.36 | $37.15 | $63.10 |
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· 4th of 51
$75.86
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.