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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $79.43 | Professional | None | $74.13 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $37.15 Typical High $39.81 | Professional | 52 · Reduced service | $37.15 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.14 Typical High $16.22 | Professional | 53 · Discontinued | $14.79 | $15.14 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $12.02 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.59 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.41 | $7.59 | $7.94 |
BCBS South Carolina Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $95.50 | Professional | None | $53.70 | $70.79 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Medcost Setting Facility Modifier None Typical Low $61.66 Median $83.18 Typical High $263.03 | Facility | None | $61.66 | $83.18 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $67.61 Typical High $104.71 | Professional | None | $64.57 | $67.61 | $104.71 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $15.14 Median $41.69 Typical High $54.95 | Professional | None | $15.14 | $41.69 | $54.95 |
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 $32.36 Median $33.88 Typical High $66.07 | Professional | 51 · Multiple procedures | $32.36 | $33.88 | $66.07 |
Where South Carolina sits
The same service costs 2.9 times more in Hawaii than in New York. 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· 28th of 51
$70.79
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.