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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | None | $70.79 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $35.48 Typical High $38.90 | Professional | 52 · Reduced service | $35.48 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $15.49 | Professional | 53 · Discontinued | $14.13 | $14.13 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $11.48 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.76 |
BCBS South Carolina Setting Professional Modifier None Typical Low $51.29 Median $67.61 Typical High $89.13 | Professional | None | $51.29 | $67.61 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Medcost Setting Facility Modifier None Typical Low $58.88 Median $77.62 Typical High $245.47 | Facility | None | $58.88 | $77.62 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $64.57 Typical High $100.00 | Professional | None | $61.66 | $64.57 | $100.00 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $10.00 Median $36.31 Typical High $50.12 | Professional | None | $10.00 | $36.31 | $50.12 |
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 $30.90 Median $32.36 Typical High $63.10 | Professional | 51 · Multiple procedures | $30.90 | $32.36 | $63.10 |
Where South Carolina sits
The same service costs 3.2 times more in Hawaii than in New York. 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· 28th of 51
$67.61
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.