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 $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $17.78 Typical High $18.20 | Professional | None | $16.98 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.71 Median $8.91 Typical High $9.12 | Professional | 52 · Reduced service | $8.71 | $8.91 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.55 Typical High $3.72 | Professional | 53 · Discontinued | $3.47 | $3.55 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $2.69 Typical High $2.75 | Professional | 55 · Aftercare only | $2.63 | $2.69 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.78 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.74 | $1.78 | $1.82 |
BCBS South Carolina Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $22.39 | Professional | None | $16.98 | $16.98 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Medcost Setting Facility Modifier None Typical Low $14.79 Median $19.50 Typical High $61.66 | Facility | None | $14.79 | $19.50 | $61.66 |
Medcost Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $25.12 | Professional | None | $15.85 | $15.85 | $25.12 |
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 $6.03 Median $10.00 Typical High $13.18 | Professional | None | $6.03 | $10.00 | $13.18 |
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 $7.94 Median $7.94 Typical High $15.85 | Professional | 51 · Multiple procedures | $7.94 | $7.94 | $15.85 |
Where South Carolina sits
The same service costs 3.2 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· 17th of 51
$16.98
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.