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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | None | $45.71 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $22.91 Typical High $24.55 | Professional | 52 · Reduced service | $22.91 | $22.91 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $9.77 | Professional | 53 · Discontinued | $9.12 | $9.12 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $7.41 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $4.90 |
BCBS South Carolina Setting Professional Modifier None Typical Low $33.11 Median $42.66 Typical High $57.54 | Professional | None | $33.11 | $42.66 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Medcost Setting Facility Modifier None Typical Low $37.15 Median $50.12 Typical High $158.49 | Facility | None | $37.15 | $50.12 | $158.49 |
Medcost Setting Professional Modifier None Typical Low $39.81 Median $40.74 Typical High $64.57 | Professional | None | $39.81 | $40.74 | $64.57 |
United Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
United Setting Professional Modifier None Typical Low $10.00 Median $25.12 Typical High $32.36 | Professional | None | $10.00 | $25.12 | $32.36 |
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 $19.50 Median $20.42 Typical High $39.81 | Professional | 51 · Multiple procedures | $19.50 | $20.42 | $39.81 |
Where South Carolina sits
The same service costs 2.6 times more in Hawaii than in Utah. 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
$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.