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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $89.13 | Professional | None | $81.28 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $40.74 Typical High $43.65 | Professional | 52 · Reduced service | $40.74 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $17.78 | Professional | 53 · Discontinued | $16.22 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.30 Typical High $13.18 | Professional | 55 · Aftercare only | $12.02 | $12.30 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $8.71 |
BCBS South Carolina Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $102.33 | Professional | None | $58.88 | $75.86 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Medcost Setting Facility Modifier None Typical Low $67.61 Median $89.13 Typical High $281.84 | Facility | None | $67.61 | $89.13 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $114.82 | Professional | None | $70.79 | $74.13 | $114.82 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $15.14 Median $45.71 Typical High $56.23 | Professional | None | $15.14 | $45.71 | $56.23 |
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 $35.48 Median $37.15 Typical High $72.44 | Professional | 51 · Multiple procedures | $35.48 | $37.15 | $72.44 |
Where South Carolina sits
The same service costs 2.5 times more in Montana than in Missouri. 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
$75.86
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.