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 $501.19 Median $501.19 Typical High $645.65 | Facility | None | $501.19 | $501.19 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $812.83 | Professional | None | $426.58 | $537.03 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $794.33 Typical High $1,000.00 | Professional | None | $416.87 | $794.33 | $1,000.00 |
BCBS South Carolina Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $588.84 | Professional | None | $302.00 | $446.68 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $891.25 Typical High $1,995.26 | Facility | None | $602.56 | $891.25 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $870.96 | Professional | None | $338.84 | $457.09 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $257.04 Median $549.54 Typical High $1,288.25 | Facility | None | $257.04 | $549.54 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $741.31 | Professional | None | $436.52 | $524.81 | $741.31 |
Molina Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,096.48 | Professional | None | $549.54 | $794.33 | $1,096.48 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,258.93 Typical High $8,709.64 | Facility | None | $389.05 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $812.83 | Professional | None | $346.74 | $501.19 | $812.83 |
8 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 $213.80 Median $245.47 Typical High $316.23 | Professional | 52 · Reduced service | $213.80 | $245.47 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $74.13 Typical High $95.50 | Professional | 55 · Aftercare only | $63.10 | $74.13 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $50.12 Typical High $64.57 | Professional | 56 · Pre-op care only | $42.66 | $50.12 | $64.57 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $269.15 Typical High $446.68 | Professional | 51 · Multiple procedures | $218.78 | $269.15 | $446.68 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $107.15 Typical High $181.97 | Professional | 80 · Assistant surgeon | $87.10 | $107.15 | $181.97 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $61.66 Median $74.13 Typical High $125.89 | Professional | 81 · Minimal assistant surgeon | $61.66 | $74.13 | $125.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $61.66 Median $74.13 Typical High $125.89 | Professional | 82 · Assistant surgeon, no resident | $61.66 | $74.13 | $125.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $74.13 Typical High $125.89 | Professional | AS · PA/NP assist | $61.66 | $74.13 | $125.89 |
Where South Carolina sits
The same service costs 3.1 times more in Alaska than in Indiana. 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
$550
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.