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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $93.33 | Professional | None | $87.10 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $43.65 Typical High $46.77 | Professional | 52 · Reduced service | $43.65 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $19.05 | Professional | 53 · Discontinued | $17.38 | $17.38 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.18 Typical High $14.13 | Professional | 55 · Aftercare only | $12.88 | $13.18 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $9.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $109.65 | Professional | None | $63.10 | $81.28 | $109.65 |
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 $72.44 Median $95.50 Typical High $302.00 | Facility | None | $72.44 | $95.50 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $123.03 | Professional | None | $75.86 | $79.43 | $123.03 |
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 $44.67 Median $51.29 Typical High $63.10 | Professional | None | $44.67 | $51.29 | $63.10 |
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 $38.02 Median $39.81 Typical High $77.62 | Professional | 51 · Multiple procedures | $38.02 | $39.81 | $77.62 |
Where South Carolina sits
The same service costs 3.2 times more in Hawaii than in Arizona. 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
$81.28
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.