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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $57.54 | Professional | None | $52.48 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $26.92 Typical High $28.84 | Professional | 52 · Reduced service | $26.30 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $11.48 | Professional | 53 · Discontinued | $10.72 | $10.72 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $8.51 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.37 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.25 | $5.37 | $5.75 |
BCBS South Carolina Setting Professional Modifier None Typical Low $38.90 Median $50.12 Typical High $67.61 | Professional | None | $38.90 | $50.12 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $58.88 Typical High $186.21 | Facility | None | $43.65 | $58.88 | $186.21 |
Medcost Setting Professional Modifier None Typical Low $45.71 Median $47.86 Typical High $75.86 | Professional | None | $45.71 | $47.86 | $75.86 |
United Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
United Setting Professional Modifier None Typical Low $10.00 Median $29.51 Typical High $37.15 | Professional | None | $10.00 | $29.51 | $37.15 |
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 $22.91 Median $23.99 Typical High $46.77 | Professional | 51 · Multiple procedures | $22.91 | $23.99 | $46.77 |
Where South Carolina sits
The same service costs 2.8 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· 19th of 51
$50.12
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.