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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $67.61 | Professional | None | $61.66 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $30.90 Typical High $33.88 | Professional | 52 · Reduced service | $30.90 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.59 Typical High $13.49 | Professional | 53 · Discontinued | $12.30 | $12.59 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $10.00 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $6.76 |
BCBS South Carolina Setting Professional Modifier None Typical Low $44.67 Median $57.54 Typical High $77.62 | Professional | None | $44.67 | $57.54 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Medcost Setting Facility Modifier None Typical Low $51.29 Median $69.18 Typical High $218.78 | Facility | None | $51.29 | $69.18 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $53.70 Median $56.23 Typical High $87.10 | Professional | None | $53.70 | $56.23 | $87.10 |
United Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
United Setting Professional Modifier None Typical Low $32.36 Median $36.31 Typical High $45.71 | Professional | None | $32.36 | $36.31 | $45.71 |
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 $26.92 Median $28.18 Typical High $54.95 | Professional | 51 · Multiple procedures | $26.92 | $28.18 | $54.95 |
Where South Carolina sits
The same service costs 3.0 times more in Hawaii 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· 29th of 51
$57.54
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.