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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $128.82 | Professional | None | $120.23 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $60.26 Typical High $64.57 | Professional | 52 · Reduced service | $60.26 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $26.30 | Professional | 53 · Discontinued | $23.99 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $18.20 Typical High $19.50 | Professional | 55 · Aftercare only | $17.78 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $12.88 |
BCBS South Carolina Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $151.36 | Professional | None | $85.11 | $112.20 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Medcost Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $416.87 | Facility | None | $100.00 | $131.83 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $104.71 Median $109.65 Typical High $169.82 | Professional | None | $104.71 | $109.65 | $169.82 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $61.66 Median $70.79 Typical High $87.10 | Professional | None | $61.66 | $70.79 | $87.10 |
4 more rates 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 $52.48 Median $54.95 Typical High $107.15 | Professional | 51 · Multiple procedures | $52.48 | $54.95 | $107.15 |
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where South Carolina sits
The same service costs 2.6 times more in Montana than in Ohio. 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· 31st of 51
$112
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.