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 $33.11 Median $33.11 Typical High $35.48 | Professional | None | $33.11 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.60 Median $16.60 Typical High $17.78 | Professional | 52 · Reduced service | $16.60 | $16.60 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $7.08 | Professional | 53 · Discontinued | $6.61 | $6.61 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $5.37 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.55 |
BCBS South Carolina Setting Professional Modifier None Typical Low $23.99 Median $30.90 Typical High $41.69 | Professional | None | $23.99 | $30.90 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Medcost Setting Facility Modifier None Typical Low $27.54 Median $36.31 Typical High $114.82 | Facility | None | $27.54 | $36.31 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $28.84 Median $30.20 Typical High $46.77 | Professional | None | $28.84 | $30.20 | $46.77 |
United Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
United Setting Professional Modifier None Typical Low $10.00 Median $18.20 Typical High $24.55 | Professional | None | $10.00 | $18.20 | $24.55 |
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 $14.45 Median $15.14 Typical High $28.84 | Professional | 51 · Multiple procedures | $14.45 | $15.14 | $28.84 |
Where South Carolina sits
The same service costs 3.2 times more in Montana than in Indiana. 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· 27th of 51
$30.90
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.