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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $54.95 | Professional | None | $51.29 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $25.70 Typical High $27.54 | Professional | 52 · Reduced service | $25.70 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $10.96 | Professional | 53 · Discontinued | $10.23 | $10.23 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $8.32 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $5.50 |
BCBS South Carolina Setting Professional Modifier None Typical Low $37.15 Median $47.86 Typical High $64.57 | Professional | None | $37.15 | $47.86 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Medcost Setting Facility Modifier None Typical Low $41.69 Median $56.23 Typical High $177.83 | Facility | None | $41.69 | $56.23 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $43.65 Median $45.71 Typical High $72.44 | Professional | None | $43.65 | $45.71 | $72.44 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $15.14 Median $28.18 Typical High $37.15 | Professional | None | $15.14 | $28.18 | $37.15 |
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 $21.88 Median $22.91 Typical High $44.67 | Professional | 51 · Multiple procedures | $21.88 | $22.91 | $44.67 |
Where South Carolina sits
The same service costs 4.2 times more in Minnesota than in Alaska. 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· 26th of 51
$47.86
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.