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 $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $53.70 | Professional | None | $50.12 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $25.12 Typical High $26.92 | Professional | 52 · Reduced service | $24.55 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $10.72 | Professional | 53 · Discontinued | $10.00 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $8.13 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $5.37 |
BCBS South Carolina Setting Professional Modifier None Typical Low $36.31 Median $46.77 Typical High $63.10 | Professional | None | $36.31 | $46.77 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Medcost Setting Facility Modifier None Typical Low $40.74 Median $54.95 Typical High $173.78 | Facility | None | $40.74 | $54.95 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $43.65 Median $44.67 Typical High $70.79 | Professional | None | $43.65 | $44.67 | $70.79 |
United Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $12.02 Median $27.54 Typical High $36.31 | Professional | None | $12.02 | $27.54 | $36.31 |
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 $21.88 Median $22.39 Typical High $43.65 | Professional | 51 · Multiple procedures | $21.88 | $22.39 | $43.65 |
Where South Carolina sits
The same service costs 2.8 times more in Montana than in Ohio. 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
$46.77
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.