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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | None | $67.61 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $33.88 Typical High $35.48 | Professional | 52 · Reduced service | $33.11 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $14.13 | Professional | 53 · Discontinued | $13.49 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $10.72 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $7.08 |
BCBS South Carolina Setting Professional Modifier None Typical Low $48.98 Median $63.10 Typical High $85.11 | Professional | None | $48.98 | $63.10 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Medcost Setting Facility Modifier None Typical Low $56.23 Median $74.13 Typical High $234.42 | Facility | None | $56.23 | $74.13 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $58.88 Median $61.66 Typical High $95.50 | Professional | None | $58.88 | $61.66 | $95.50 |
United Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
United Setting Professional Modifier None Typical Low $12.02 Median $38.02 Typical High $46.77 | Professional | None | $12.02 | $38.02 | $46.77 |
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 $29.51 Median $30.90 Typical High $60.26 | Professional | 51 · Multiple procedures | $29.51 | $30.90 | $60.26 |
Where South Carolina sits
The same service costs 2.6 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· 23rd of 51
$63.10
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.