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 $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $21.38 Typical High $21.88 | Professional | None | $17.78 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.91 Median $10.72 Typical High $10.96 | Professional | 52 · Reduced service | $8.91 | $10.72 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $4.27 Typical High $4.37 | Professional | 53 · Discontinued | $3.55 | $4.27 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $3.16 Typical High $3.31 | Professional | 55 · Aftercare only | $2.69 | $3.16 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $2.14 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.78 | $2.14 | $2.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | None | $19.95 | $19.95 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Medcost Setting Facility Modifier None Typical Low $17.38 Median $23.44 Typical High $74.13 | Facility | None | $17.38 | $23.44 | $74.13 |
Medcost Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $30.20 | Professional | None | $19.05 | $19.05 | $30.20 |
United Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
United Setting Professional Modifier None Typical Low $8.13 Median $12.88 Typical High $16.98 | Professional | None | $8.13 | $12.88 | $16.98 |
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 $9.55 Median $9.55 Typical High $18.62 | Professional | 51 · Multiple procedures | $9.55 | $9.55 | $18.62 |
Where South Carolina sits
The same service costs 3.0 times more in Montana 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· 10th of 51
$19.95
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.