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 $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $120.23 | Professional | None | $114.82 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $57.54 Typical High $60.26 | Professional | 52 · Reduced service | $57.54 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $24.55 | Professional | 53 · Discontinued | $22.91 | $22.91 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $18.20 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $12.02 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $12.02 |
BCBS South Carolina Setting Facility Modifier None Typical Low $169.82 Median $218.78 Typical High $245.47 | Facility | None | $169.82 | $218.78 | $245.47 |
BCBS South Carolina Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $199.53 | Professional | None | $144.54 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Medcost Setting Facility Modifier None Typical Low $112.20 Median $154.88 Typical High $239.88 | Facility | None | $112.20 | $154.88 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $162.18 | Professional | None | $112.20 | $112.20 | $162.18 |
United Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $89.13 | Professional | None | $50.12 | $67.61 | $89.13 |
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 $56.23 Median $56.23 Typical High $102.33 | Professional | 51 · Multiple procedures | $56.23 | $56.23 | $102.33 |
Where South Carolina sits
The same service costs 3.0 times more in California than in New York. 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· 19th of 51
$115
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.