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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $46.77 | Professional | None | $43.65 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $21.38 Typical High $23.44 | Professional | 52 · Reduced service | $21.38 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $9.33 | Professional | 53 · Discontinued | $8.71 | $8.71 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $7.08 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.68 |
BCBS South Carolina Setting Professional Modifier None Typical Low $30.90 Median $40.74 Typical High $54.95 | Professional | None | $30.90 | $40.74 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
Medcost Setting Facility Modifier None Typical Low $35.48 Median $47.86 Typical High $151.36 | Facility | None | $35.48 | $47.86 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $61.66 | Professional | None | $37.15 | $38.90 | $61.66 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $12.02 Median $23.99 Typical High $32.36 | Professional | None | $12.02 | $23.99 | $32.36 |
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 $18.62 Median $19.50 Typical High $38.02 | Professional | 51 · Multiple procedures | $18.62 | $19.50 | $38.02 |
Where South Carolina sits
The same service costs 3.9 times more in Montana than in Alaska. 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
$40.74
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.