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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $64.57 | Professional | None | $58.88 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $29.51 Typical High $32.36 | Professional | 52 · Reduced service | $29.51 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $12.88 | Professional | 53 · Discontinued | $11.75 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $9.55 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $6.46 |
BCBS South Carolina Setting Professional Modifier None Typical Low $44.67 Median $54.95 Typical High $74.13 | Professional | None | $44.67 | $54.95 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Medcost Setting Facility Modifier None Typical Low $48.98 Median $64.57 Typical High $204.17 | Facility | None | $48.98 | $64.57 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $83.18 | Professional | None | $52.48 | $52.48 | $83.18 |
United Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $30.20 Median $34.67 Typical High $43.65 | Professional | None | $30.20 | $34.67 | $43.65 |
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 $25.70 Median $26.30 Typical High $52.48 | Professional | 51 · Multiple procedures | $25.70 | $26.30 | $52.48 |
Where South Carolina sits
The same service costs 2.8 times more in Montana than in Alabama. 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
$54.95
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.