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 $53.70 Median $53.70 Typical High $58.88 | Professional | None | $53.70 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $26.92 Typical High $29.51 | Professional | 52 · Reduced service | $26.92 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $11.75 | Professional | 53 · Discontinued | $10.72 | $10.72 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.71 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $38.90 Median $51.29 Typical High $67.61 | Professional | None | $38.90 | $51.29 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Medcost Setting Facility Modifier None Typical Low $44.67 Median $58.88 Typical High $186.21 | Facility | None | $44.67 | $58.88 | $186.21 |
Medcost Setting Professional Modifier None Typical Low $46.77 Median $48.98 Typical High $75.86 | Professional | None | $46.77 | $48.98 | $75.86 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
United Setting Professional Modifier None Typical Low $10.00 Median $30.20 Typical High $38.02 | Professional | None | $10.00 | $30.20 | $38.02 |
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 $23.44 Median $24.55 Typical High $47.86 | Professional | 51 · Multiple procedures | $23.44 | $24.55 | $47.86 |
Where South Carolina sits
The same service costs 2.7 times more in Hawaii than in Alabama. 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
$51.29
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.