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 $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $13.49 Typical High $14.79 | Professional | None | $11.48 | $13.49 | $14.79 |
BCBS South Carolina Setting Professional Modifier None Typical Low $16.98 Median $18.20 Typical High $18.20 | Professional | None | $16.98 | $18.20 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Medcost Setting Facility Modifier None Typical Low $13.18 Median $13.49 Typical High $47.86 | Facility | None | $13.18 | $13.49 | $47.86 |
Medcost Setting Professional Modifier None Typical Low $12.88 Median $14.79 Typical High $22.91 | Professional | None | $12.88 | $14.79 | $22.91 |
United Setting Professional Modifier None Typical Low $5.89 Median $8.32 Typical High $10.47 | Professional | None | $5.89 | $8.32 | $10.47 |
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 $5.75 Median $6.76 Typical High $7.41 | Professional | 52 · Reduced service | $5.75 | $6.76 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.69 Typical High $2.95 | Professional | 53 · Discontinued | $2.29 | $2.69 | $2.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.51 Median $10.00 Typical High $10.96 | Professional | 54 · Surgery only | $8.51 | $10.00 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $2.04 Typical High $2.19 | Professional | 55 · Aftercare only | $1.70 | $2.04 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.35 Typical High $1.48 | Professional | 56 · Pre-op care only | $1.12 | $1.35 | $1.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.31 Median $7.41 Typical High $14.45 | Professional | 51 · Multiple procedures | $6.31 | $7.41 | $14.45 |
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
$16.98
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.