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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $63.10 Typical High $64.57 | Professional | None | $61.66 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $31.62 Typical High $32.36 | Professional | 52 · Reduced service | $30.90 | $31.62 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $12.88 | Professional | 53 · Discontinued | $12.59 | $12.59 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.55 Typical High $9.77 | Professional | 55 · Aftercare only | $9.33 | $9.55 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.31 Typical High $6.46 | Professional | 56 · Pre-op care only | $6.17 | $6.31 | $6.46 |
BCBS South Carolina Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $79.43 | Professional | None | $58.88 | $58.88 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Medcost Setting Facility Modifier None Typical Low $52.48 Median $69.18 Typical High $218.78 | Facility | None | $52.48 | $69.18 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $54.95 Median $57.54 Typical High $89.13 | Professional | None | $54.95 | $57.54 | $89.13 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $19.05 Median $34.67 Typical High $46.77 | Professional | None | $19.05 | $34.67 | $46.77 |
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 $27.54 Median $28.84 Typical High $56.23 | Professional | 51 · Multiple procedures | $27.54 | $28.84 | $56.23 |
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· 20th of 51
$58.88
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.