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 $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $33.11 Typical High $36.31 | Professional | None | $26.92 | $33.11 | $36.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $43.65 | Professional | None | $42.66 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Medcost Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $117.49 | Facility | None | $33.11 | $33.11 | $117.49 |
Medcost Setting Professional Modifier None Typical Low $26.92 Median $42.66 Typical High $56.23 | Professional | None | $26.92 | $42.66 | $56.23 |
United Setting Professional Modifier None Typical Low $14.79 Median $20.89 Typical High $25.70 | Professional | None | $14.79 | $20.89 | $25.70 |
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 $13.80 Median $16.60 Typical High $18.20 | Professional | 52 · Reduced service | $13.80 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $6.76 Typical High $7.41 | Professional | 53 · Discontinued | $5.50 | $6.76 | $7.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.42 Median $25.12 Typical High $27.54 | Professional | 54 · Surgery only | $20.42 | $25.12 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $5.01 Typical High $5.50 | Professional | 55 · Aftercare only | $4.17 | $5.01 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $3.39 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.75 | $3.39 | $3.63 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $13.49 Median $21.38 Typical High $36.31 | Professional | 51 · Multiple procedures | $13.49 | $21.38 | $36.31 |
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
$42.66
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.