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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $74.13 Typical High $77.62 | Professional | None | $72.44 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $37.15 Typical High $38.90 | Professional | 52 · Reduced service | $36.31 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.79 Typical High $15.49 | Professional | 53 · Discontinued | $14.45 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.22 Typical High $11.48 | Professional | 55 · Aftercare only | $10.96 | $11.22 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.41 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.24 | $7.41 | $7.76 |
BCBS South Carolina Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $93.33 | Professional | None | $53.70 | $70.79 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Medcost Setting Facility Modifier None Typical Low $61.66 Median $81.28 Typical High $257.04 | Facility | None | $61.66 | $81.28 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $67.61 Typical High $104.71 | Professional | None | $64.57 | $67.61 | $104.71 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $10.00 Median $36.31 Typical High $52.48 | Professional | None | $10.00 | $36.31 | $52.48 |
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 $32.36 Median $33.88 Typical High $66.07 | Professional | 51 · Multiple procedures | $32.36 | $33.88 | $66.07 |
Where South Carolina sits
The same service costs 2.6 times more in Montana than in Nebraska. 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· 11th of 51
$70.79
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.