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 $85.11 Median $9,120.11 Typical High $22,908.68 | Facility | None | $85.11 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $85.11 | Professional | None | $75.86 | $85.11 | $85.11 |
BCBS South Carolina Setting Facility Modifier None Typical Low $134.90 Median $245.47 Typical High $426.58 | Facility | None | $134.90 | $245.47 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $457.09 Typical High $741.31 | Facility | None | $75.86 | $457.09 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $107.15 | Professional | None | $66.07 | $79.43 | $107.15 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $114.82 | Facility | None | $66.07 | $102.33 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $91.20 | Professional | None | $70.79 | $75.86 | $91.20 |
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 $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $58.88 Median $72.44 Typical High $131.83 | Professional | None | $58.88 | $72.44 | $131.83 |
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 $38.02 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $38.02 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $15.14 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $63.10 Typical High $63.10 | Professional | 54 · Surgery only | $56.23 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $11.22 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.59 | $8.51 | $8.51 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $35.48 Median $38.02 Typical High $56.23 | Professional | 51 · Multiple procedures | $35.48 | $38.02 | $56.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.45 Median $15.14 Typical High $22.39 | Professional | 80 · Assistant surgeon | $14.45 | $15.14 | $22.39 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.00 Median $10.72 Typical High $15.49 | Professional | 81 · Minimal assistant surgeon | $10.00 | $10.72 | $15.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.00 Median $10.72 Typical High $15.49 | Professional | 82 · Assistant surgeon, no resident | $10.00 | $10.72 | $15.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.00 Median $10.72 Typical High $15.49 | Professional | AS · PA/NP assist | $10.00 | $10.72 | $15.49 |
Where South Carolina sits
The same service costs 5.5 times more in Arkansas than in Kentucky. 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· 28th of 51
$100
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.