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 $37.15 Median $5,623.41 Typical High $21,877.62 | Facility | None | $37.15 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $37.15 Typical High $37.15 | Professional | None | $20.89 | $37.15 | $37.15 |
BCBS South Carolina Setting Professional Modifier None Typical Low $31.62 Median $50.12 Typical High $50.12 | Professional | None | $31.62 | $50.12 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $416.87 Typical High $891.25 | Facility | None | $154.88 | $416.87 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $60.26 Typical High $158.49 | Professional | None | $38.90 | $60.26 | $158.49 |
Medcost Setting Facility Modifier None Typical Low $22.39 Median $47.86 Typical High $218.78 | Facility | None | $22.39 | $47.86 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $20.42 Median $51.29 Typical High $51.29 | Professional | None | $20.42 | $51.29 | $51.29 |
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 $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $21.38 Median $32.36 Typical High $61.66 | Professional | None | $21.38 | $32.36 | $61.66 |
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 $10.47 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $10.47 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $4.17 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.60 Median $28.18 Typical High $28.18 | Professional | 54 · Surgery only | $16.60 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $3.16 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.09 | $3.72 | $3.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $13.18 Median $25.70 Typical High $25.70 | Professional | 51 · Multiple procedures | $13.18 | $25.70 | $25.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.37 Median $10.23 Typical High $10.23 | Professional | 80 · Assistant surgeon | $5.37 | $10.23 | $10.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.72 Median $7.08 Typical High $7.08 | Professional | 81 · Minimal assistant surgeon | $3.72 | $7.08 | $7.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.72 Median $7.08 Typical High $7.08 | Professional | 82 · Assistant surgeon, no resident | $3.72 | $7.08 | $7.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.72 Median $7.08 Typical High $7.08 | Professional | AS · PA/NP assist | $3.72 | $7.08 | $7.08 |
Where South Carolina sits
The same service costs 9.1 times more in Tennessee than in Maine. 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· 40th of 51
$50.12
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.