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 $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $181.97 | Professional | None | $169.82 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | 52 · Reduced service | $85.11 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $34.67 Typical High $36.31 | Professional | 53 · Discontinued | $33.88 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $26.92 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $18.20 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $18.20 |
BCBS South Carolina Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $218.78 | Professional | None | $123.03 | $158.49 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $190.55 Typical High $602.56 | Facility | None | $141.25 | $190.55 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $239.88 | Professional | None | $147.91 | $154.88 | $239.88 |
United Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
United Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $125.89 | Professional | None | $89.13 | $100.00 | $125.89 |
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 $74.13 Median $77.62 Typical High $151.36 | Professional | 51 · Multiple procedures | $74.13 | $77.62 | $151.36 |
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 3.3 times more in Alaska 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· 30th of 51
$158
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.