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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | None | $147.91 | $147.91 | $151.36 |
BCBS South Carolina Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $181.97 | Professional | None | $147.91 | $158.49 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $295.12 Typical High $371.54 | Facility | None | $173.78 | $295.12 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Medcost Setting Facility Modifier None Typical Low $147.91 Median $177.83 Typical High $199.53 | Facility | None | $147.91 | $177.83 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $181.97 | Professional | None | $169.82 | $169.82 | $181.97 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $181.97 | Professional | None | $151.36 | $181.97 | $181.97 |
5 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 $74.13 Median $74.13 Typical High $75.86 | Professional | 52 · Reduced service | $74.13 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $30.90 | Professional | 53 · Discontinued | $29.51 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $22.91 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $15.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 51 · Multiple procedures | $85.11 | $85.11 | $85.11 |
Where South Carolina sits
The same service costs 2.2 times more in North Carolina than in Michigan. 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· 22nd 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.