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 $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $144.54 | Professional | None | $109.65 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $69.18 Typical High $72.44 | Professional | 52 · Reduced service | $54.95 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $27.54 Typical High $28.84 | Professional | 53 · Discontinued | $21.88 | $27.54 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.89 Typical High $21.38 | Professional | 55 · Aftercare only | $16.60 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.80 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.96 | $13.80 | $14.45 |
BCBS South Carolina Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $173.78 | Professional | None | $100.00 | $128.82 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $151.36 Typical High $478.63 | Facility | None | $114.82 | $151.36 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $194.98 | Professional | None | $120.23 | $125.89 | $194.98 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
United Setting Professional Modifier None Typical Low $15.14 Median $64.57 Typical High $97.72 | Professional | None | $15.14 | $64.57 | $97.72 |
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 $60.26 Median $63.10 Typical High $123.03 | Professional | 51 · Multiple procedures | $60.26 | $63.10 | $123.03 |
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· 6th of 51
$129
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.