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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $93.33 Typical High $95.50 | Professional | None | $91.20 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $46.77 Typical High $47.86 | Professional | 52 · Reduced service | $45.71 | $46.77 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.62 Typical High $19.05 | Professional | 53 · Discontinued | $18.20 | $18.62 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $14.45 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.33 Typical High $9.55 | Professional | 56 · Pre-op care only | $9.12 | $9.33 | $9.55 |
BCBS South Carolina Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $117.49 | Professional | None | $67.61 | $87.10 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Medcost Setting Facility Modifier None Typical Low $77.62 Median $102.33 Typical High $323.59 | Facility | None | $77.62 | $102.33 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $131.83 | Professional | None | $81.28 | $85.11 | $131.83 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
United Setting Professional Modifier None Typical Low $15.14 Median $51.29 Typical High $64.57 | Professional | None | $15.14 | $51.29 | $64.57 |
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 $40.74 Median $41.69 Typical High $81.28 | Professional | 51 · Multiple procedures | $40.74 | $41.69 | $81.28 |
Where South Carolina sits
The same service costs 4.2 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· 23rd of 51
$87.10
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.