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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $61.66 | Professional | None | $56.23 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.18 Typical High $30.90 | Professional | 52 · Reduced service | $28.18 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $12.30 | Professional | 53 · Discontinued | $11.48 | $11.48 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $9.33 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $6.17 |
BCBS South Carolina Setting Professional Modifier None Typical Low $40.74 Median $52.48 Typical High $72.44 | Professional | None | $40.74 | $52.48 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Medcost Setting Facility Modifier None Typical Low $46.77 Median $63.10 Typical High $199.53 | Facility | None | $46.77 | $63.10 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $51.29 Typical High $79.43 | Professional | None | $50.12 | $51.29 | $79.43 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $10.00 Median $31.62 Typical High $39.81 | Professional | None | $10.00 | $31.62 | $39.81 |
1 more rate 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $25.12 Median $25.70 Typical High $50.12 | Professional | 51 · Multiple procedures | $25.12 | $25.70 | $50.12 |
Where South Carolina sits
The same service costs 3.1 times more in Montana 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· 26th of 51
$52.48
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.