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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $63.10 | Professional | None | $60.26 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.20 Typical High $31.62 | Professional | 52 · Reduced service | $30.20 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.59 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.12 Typical High $9.33 | Professional | 55 · Aftercare only | $8.91 | $9.12 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.31 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $43.65 Median $57.54 Typical High $75.86 | Professional | None | $43.65 | $57.54 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Medcost Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $208.93 | Facility | None | $50.12 | $66.07 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $54.95 Typical High $85.11 | Professional | None | $52.48 | $54.95 | $85.11 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $12.02 Median $33.88 Typical High $42.66 | Professional | None | $12.02 | $33.88 | $42.66 |
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 $26.30 Median $27.54 Typical High $53.70 | Professional | 51 · Multiple procedures | $26.30 | $27.54 | $53.70 |
Where South Carolina sits
The same service costs 2.9 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· 19th of 51
$57.54
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.