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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $125.89 Typical High $251.19 | Professional | None | $123.03 | $125.89 | $251.19 |
BCBS South Carolina Setting Facility Modifier None Typical Low $275.42 Median $467.74 Typical High $812.83 | Facility | None | $275.42 | $467.74 | $812.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $204.17 | Professional | None | $104.71 | $144.54 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $194.98 | Professional | None | $104.71 | $120.23 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $173.78 Typical High $223.87 | Professional | None | $169.82 | $173.78 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $138.04 Typical High $338.84 | Facility | None | $114.82 | $138.04 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $223.87 | Professional | None | $117.49 | $141.25 | $223.87 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $190.55 | Professional | None | $95.50 | $123.03 | $190.55 |
United Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $181.97 | Professional | None | $102.33 | $123.03 | $181.97 |
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 $61.66 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $61.66 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $24.55 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $18.20 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.30 | $12.59 | $12.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $58.88 Median $75.86 Typical High $114.82 | Professional | 51 · Multiple procedures | $58.88 | $75.86 | $114.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $23.44 Median $30.20 Typical High $45.71 | Professional | 80 · Assistant surgeon | $23.44 | $30.20 | $45.71 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.60 Median $21.38 Typical High $32.36 | Professional | 81 · Minimal assistant surgeon | $16.60 | $21.38 | $32.36 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.60 Median $21.38 Typical High $32.36 | Professional | 82 · Assistant surgeon, no resident | $16.60 | $21.38 | $32.36 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.60 Median $21.38 Typical High $32.36 | Professional | AS · PA/NP assist | $16.60 | $21.38 | $32.36 |
Where South Carolina sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 38th of 51
$126
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.