How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $194.98 Median $5,623.41 Typical High $21,877.62 | Facility | None | $194.98 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
BCBS South Carolina Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $3,981.07 | Facility | None | $501.19 | $794.33 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,659.59 Typical High $2,398.83 | Facility | None | $602.56 | $1,659.59 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $194.98 Median $234.42 Typical High $1,778.28 | Facility | None | $194.98 | $234.42 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $281.84 | Professional | None | $194.98 | $194.98 | $281.84 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $21,379.62 | Facility | None | $1,445.44 | $4,265.80 | $21,379.62 |
United Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $416.87 | Professional | None | $190.55 | $269.15 | $416.87 |
10 more rates 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $95.50 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 54 · Surgery only | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $19.50 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $97.72 Median $97.72 Typical High $181.97 | Professional | 51 · Multiple procedures | $97.72 | $97.72 | $181.97 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.90 Median $38.90 Typical High $72.44 | Professional | 80 · Assistant surgeon | $38.90 | $38.90 | $72.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $27.54 Median $27.54 Typical High $51.29 | Professional | 81 · Minimal assistant surgeon | $27.54 | $27.54 | $51.29 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $27.54 Median $27.54 Typical High $51.29 | Professional | 82 · Assistant surgeon, no resident | $27.54 | $27.54 | $51.29 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $27.54 Median $27.54 Typical High $51.29 | Professional | AS · PA/NP assist | $27.54 | $27.54 | $51.29 |
Where South Carolina sits
The same service costs 19.5 times more in Texas 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· 11th of 51
$676
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.