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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $54.95 Typical High $58.88 | Professional | None | $53.70 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $27.54 Typical High $29.51 | Professional | 52 · Reduced service | $26.92 | $27.54 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $11.75 | Professional | 53 · Discontinued | $10.96 | $10.96 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.91 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.50 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.37 | $5.50 | $5.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $38.90 Median $51.29 Typical High $69.18 | Professional | None | $38.90 | $51.29 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Medcost Setting Facility Modifier None Typical Low $44.67 Median $60.26 Typical High $190.55 | Facility | None | $44.67 | $60.26 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $46.77 Median $48.98 Typical High $77.62 | Professional | None | $46.77 | $48.98 | $77.62 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $12.02 Median $30.20 Typical High $39.81 | Professional | None | $12.02 | $30.20 | $39.81 |
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 2.8 times more in Montana than in Indiana. 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· 24th 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.