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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $89.13 Typical High $91.20 | Professional | None | $87.10 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $44.67 Typical High $45.71 | Professional | 52 · Reduced service | $43.65 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.78 Typical High $18.20 | Professional | 53 · Discontinued | $17.38 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $13.80 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.91 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.71 | $8.91 | $9.12 |
BCBS South Carolina Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $112.20 | Professional | None | $64.57 | $83.18 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Medcost Setting Facility Modifier None Typical Low $72.44 Median $97.72 Typical High $309.03 | Facility | None | $72.44 | $97.72 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $77.62 Median $79.43 Typical High $125.89 | Professional | None | $77.62 | $79.43 | $125.89 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $12.02 Median $45.71 Typical High $61.66 | Professional | None | $12.02 | $45.71 | $61.66 |
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 $38.90 Median $39.81 Typical High $77.62 | Professional | 51 · Multiple procedures | $38.90 | $39.81 | $77.62 |
Where South Carolina sits
The same service costs 2.6 times more in Hawaii 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· 21st of 51
$83.18
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.