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 $67.61 Median $67.61 Typical High $72.44 | Facility | None | $67.61 | $67.61 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $75.86 | Professional | None | $67.61 | $72.44 | $75.86 |
BCBS South Carolina Setting Facility Modifier None Typical Low $23.44 Median $34.67 Typical High $67.61 | Facility | None | $23.44 | $34.67 | $67.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $72.44 Median $89.13 Typical High $95.50 | Professional | None | $72.44 | $89.13 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $218.78 Typical High $389.05 | Facility | None | $162.18 | $218.78 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $47.86 Typical High $131.83 | Professional | None | $45.71 | $47.86 | $131.83 |
Medcost Setting Facility Modifier None Typical Low $72.44 Median $87.10 Typical High $245.47 | Facility | None | $72.44 | $87.10 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $109.65 | Professional | None | $72.44 | $72.44 | $109.65 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $144.54 | Professional | None | $83.18 | $97.72 | $144.54 |
United Setting Facility Modifier None Typical Low $707.95 Median $870.96 Typical High $1,122.02 | Facility | None | $707.95 | $870.96 | $1,122.02 |
United Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $223.87 | Professional | None | $54.95 | $95.50 | $223.87 |
9 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 $33.88 Median $36.31 Typical High $38.02 | Professional | 52 · Reduced service | $33.88 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.45 Typical High $15.14 | Professional | 53 · Discontinued | $13.49 | $14.45 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.72 Typical High $11.22 | Professional | 55 · Aftercare only | $10.23 | $10.72 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.24 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.76 | $7.24 | $7.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $36.31 Median $36.31 Typical High $69.18 | Professional | 51 · Multiple procedures | $36.31 | $36.31 | $69.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.45 Median $14.45 Typical High $27.54 | Professional | 80 · Assistant surgeon | $14.45 | $14.45 | $27.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.23 Median $10.23 Typical High $19.50 | Professional | 81 · Minimal assistant surgeon | $10.23 | $10.23 | $19.50 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.23 Median $10.23 Typical High $19.50 | Professional | 82 · Assistant surgeon, no resident | $10.23 | $10.23 | $19.50 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.23 Median $10.23 Typical High $19.50 | Professional | AS · PA/NP assist | $10.23 | $10.23 | $19.50 |
Where South Carolina sits
The same service costs 5.0 times more in Alaska than in Alabama. 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· 48th of 51
$67.61
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.