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 $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $20.89 | Professional | None | $19.95 | $19.95 | $20.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.00 Median $10.00 Typical High $10.23 | Professional | 52 · Reduced service | $10.00 | $10.00 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $4.17 | Professional | 53 · Discontinued | $3.98 | $3.98 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $3.02 Typical High $3.09 | Professional | 55 · Aftercare only | $2.95 | $3.02 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.00 Typical High $2.04 | Professional | 56 · Pre-op care only | $2.00 | $2.00 | $2.04 |
BCBS South Carolina Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $25.12 | Professional | None | $19.05 | $19.05 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Medcost Setting Facility Modifier None Typical Low $16.60 Median $21.88 Typical High $69.18 | Facility | None | $16.60 | $21.88 | $69.18 |
Medcost Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $28.18 | Professional | None | $18.20 | $18.20 | $28.18 |
United Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
United Setting Professional Modifier None Typical Low $9.77 Median $11.75 Typical High $14.79 | Professional | None | $9.77 | $11.75 | $14.79 |
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 $8.91 Median $8.91 Typical High $17.78 | Professional | 51 · Multiple procedures | $8.91 | $8.91 | $17.78 |
Where South Carolina sits
The same service costs 4.6 times more in Hawaii than in Ohio. 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· 23rd of 51
$19.05
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.