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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $158.49 | Professional | None | $120.23 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $75.86 Typical High $77.62 | Professional | 52 · Reduced service | $60.26 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $30.20 Typical High $31.62 | Professional | 53 · Discontinued | $23.99 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $22.91 Typical High $23.44 | Professional | 55 · Aftercare only | $18.20 | $22.91 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.14 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.02 | $15.14 | $15.85 |
BCBS South Carolina Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $190.55 | Professional | None | $141.25 | $141.25 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $165.96 Typical High $524.81 | Facility | None | $125.89 | $165.96 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $138.04 Typical High $213.80 | Professional | None | $131.83 | $138.04 | $213.80 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $15.14 Median $70.79 Typical High $107.15 | Professional | None | $15.14 | $70.79 | $107.15 |
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 $66.07 Median $69.18 Typical High $134.90 | Professional | 51 · Multiple procedures | $66.07 | $69.18 | $134.90 |
Where South Carolina sits
The same service costs 3.0 times more in Hawaii than in Indiana. 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
$141
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.