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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $114.82 | Professional | None | $91.20 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $54.95 Typical High $57.54 | Professional | 52 · Reduced service | $45.71 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $22.39 Typical High $22.91 | Professional | 53 · Discontinued | $18.20 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.60 Typical High $16.98 | Professional | 55 · Aftercare only | $13.80 | $16.60 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.96 Typical High $11.48 | Professional | 56 · Pre-op care only | $9.12 | $10.96 | $11.48 |
BCBS South Carolina Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $141.25 | Professional | None | $79.43 | $102.33 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $123.03 Typical High $389.05 | Facility | None | $91.20 | $123.03 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $100.00 Typical High $154.88 | Professional | None | $95.50 | $100.00 | $154.88 |
United Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
United Setting Professional Modifier None Typical Low $15.14 Median $51.29 Typical High $77.62 | Professional | None | $15.14 | $51.29 | $77.62 |
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 $47.86 Median $50.12 Typical High $97.72 | Professional | 51 · Multiple procedures | $47.86 | $50.12 | $97.72 |
Where South Carolina sits
The same service costs 2.6 times more in North Carolina 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· 8th of 51
$102
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.