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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $109.65 | Professional | None | $102.33 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $50.12 Typical High $54.95 | Professional | 52 · Reduced service | $50.12 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $21.88 | Professional | 53 · Discontinued | $20.42 | $20.42 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $16.60 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $10.96 |
BCBS South Carolina Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $128.82 | Professional | None | $72.44 | $95.50 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $112.20 Typical High $354.81 | Facility | None | $83.18 | $112.20 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $87.10 Median $89.13 Typical High $144.54 | Professional | None | $87.10 | $89.13 | $144.54 |
United Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
United Setting Professional Modifier None Typical Low $52.48 Median $60.26 Typical High $74.13 | Professional | None | $52.48 | $60.26 | $74.13 |
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 $43.65 Median $44.67 Typical High $89.13 | Professional | 51 · Multiple procedures | $43.65 | $44.67 | $89.13 |
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 2.5 times more in Minnesota than in Utah. 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· 30th of 51
$95.50
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.