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 $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $12.02 Typical High $12.30 | Professional | None | $10.96 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.89 Median $6.03 Typical High $6.17 | Professional | 52 · Reduced service | $5.89 | $6.03 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.40 Typical High $2.45 | Professional | 53 · Discontinued | $2.34 | $2.40 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $1.82 Typical High $1.86 | Professional | 55 · Aftercare only | $1.78 | $1.82 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $1.23 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $1.23 |
BCBS South Carolina Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $15.14 | Professional | None | $12.02 | $12.02 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Medcost Setting Facility Modifier None Typical Low $10.00 Median $13.18 Typical High $41.69 | Facility | None | $10.00 | $13.18 | $41.69 |
Medcost Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $16.98 | Professional | None | $10.96 | $10.96 | $16.98 |
United Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
United Setting Professional Modifier None Typical Low $5.01 Median $6.17 Typical High $8.91 | Professional | None | $5.01 | $6.17 | $8.91 |
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 $5.50 Median $5.50 Typical High $10.72 | Professional | 51 · Multiple procedures | $5.50 | $5.50 | $10.72 |
Where South Carolina sits
The same service costs 2.7 times more in Montana than in Utah. 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· 13th of 51
$12.02
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.