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 $912.01 Median $912.01 Typical High $1,174.90 | Facility | None | $912.01 | $912.01 | $1,174.90 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,412.54 | Professional | None | $741.31 | $1,000.00 | $1,412.54 |
Ambetter Setting Professional Modifier None Typical Low $776.25 Median $1,548.82 Typical High $1,862.09 | Professional | None | $776.25 | $1,548.82 | $1,862.09 |
BCBS South Carolina Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $1,000.00 | Professional | None | $512.86 | $691.83 | $1,000.00 |
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 $602.56 Median $812.83 Typical High $1,584.89 | Professional | None | $602.56 | $812.83 | $1,584.89 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $1,000.00 Typical High $2,238.72 | Facility | None | $436.52 | $1,000.00 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,348.96 | Professional | None | $758.58 | $954.99 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,445.44 | $1,995.26 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $1,445.44 | Professional | None | $602.56 | $870.96 | $1,445.44 |
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 $389.05 Median $457.09 Typical High $588.84 | Professional | 52 · Reduced service | $389.05 | $457.09 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $138.04 Typical High $173.78 | Professional | 55 · Aftercare only | $117.49 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $91.20 Typical High $117.49 | Professional | 56 · Pre-op care only | $77.62 | $91.20 | $117.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $478.63 Typical High $812.83 | Professional | 51 · Multiple procedures | $380.19 | $478.63 | $812.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $190.55 Typical High $323.59 | Professional | 80 · Assistant surgeon | $154.88 | $190.55 | $323.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $134.90 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $107.15 | $134.90 | $223.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $134.90 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $134.90 | $223.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $134.90 Typical High $223.87 | Professional | AS · PA/NP assist | $107.15 | $134.90 | $223.87 |
Where South Carolina sits
The same service costs 3.2 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· 26th of 51
$1,000
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.