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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $147.91 | Professional | None | $141.25 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $70.79 Typical High $74.13 | Professional | 52 · Reduced service | $70.79 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | 53 · Discontinued | $28.18 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $22.39 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.79 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.79 |
BCBS South Carolina Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $177.83 | Professional | None | $102.33 | $131.83 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Medcost Setting Facility Modifier None Typical Low $117.49 Median $158.49 Typical High $489.78 | Facility | None | $117.49 | $158.49 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $199.53 | Professional | None | $123.03 | $128.82 | $199.53 |
United Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
United Setting Professional Modifier None Typical Low $15.14 Median $72.44 Typical High $100.00 | Professional | None | $15.14 | $72.44 | $100.00 |
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 $61.66 Median $64.57 Typical High $125.89 | Professional | 51 · Multiple procedures | $61.66 | $64.57 | $125.89 |
Where South Carolina sits
The same service costs 5.0 times more in Hawaii than in Florida. 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· 27th of 51
$132
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.