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 $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $190.55 | Professional | None | $177.83 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $89.13 Typical High $95.50 | Professional | 52 · Reduced service | $89.13 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $38.02 | Professional | 53 · Discontinued | $35.48 | $35.48 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $28.84 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $19.05 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $19.05 |
BCBS South Carolina Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $223.87 | Professional | None | $125.89 | $162.18 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $194.98 Typical High $616.60 | Facility | None | $144.54 | $194.98 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $251.19 | Professional | None | $151.36 | $158.49 | $251.19 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
United Setting Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $128.82 | Professional | None | $91.20 | $104.71 | $128.82 |
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 $75.86 Median $77.62 Typical High $154.88 | Professional | 51 · Multiple procedures | $75.86 | $77.62 | $154.88 |
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 2.8 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· 28th of 51
$162
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.