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 $588.84 Median $5,888.44 Typical High $21,877.62 | Facility | None | $588.84 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $588.84 | Professional | None | $489.78 | $588.84 | $588.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $23.44 Median $38.90 Typical High $67.61 | Facility | None | $23.44 | $38.90 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,071.52 | Professional | None | $549.54 | $741.31 | $1,071.52 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $645.65 Typical High $794.33 | Facility | None | $588.84 | $645.65 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $707.95 | Professional | None | $524.81 | $660.69 | $707.95 |
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 |
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 $245.47 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $245.47 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $97.72 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $363.08 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $72.44 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $48.98 | $58.88 | $58.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $331.13 Median $331.13 Typical High $457.09 | Professional | 51 · Multiple procedures | $331.13 | $331.13 | $457.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $134.90 Typical High $181.97 | Professional | 80 · Assistant surgeon | $134.90 | $134.90 | $181.97 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | 81 · Minimal assistant surgeon | $93.33 | $93.33 | $125.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | 82 · Assistant surgeon, no resident | $93.33 | $93.33 | $125.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | AS · PA/NP assist | $93.33 | $93.33 | $125.89 |
Where South Carolina sits
The same service costs 134.9 times more in Oklahoma than in Hawaii. 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· 44th of 51
$479
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.