How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $851.14 | Professional | None | $794.33 | $851.14 | $851.14 |
BCBS South Carolina Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $691.83 | Professional | None | $588.84 | $645.65 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $1,230.27 | Professional | None | $691.83 | $724.44 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $933.25 Typical High $1,148.15 | Facility | None | $676.08 | $933.25 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $954.99 | Professional | None | $630.96 | $776.25 | $954.99 |
United Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $912.01 | Professional | None | $389.05 | $501.19 | $912.01 |
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 $398.11 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $398.11 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $162.18 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $120.23 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $79.43 | $85.11 | $85.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $389.05 Typical High $588.84 | Professional | 51 · Multiple procedures | $316.23 | $389.05 | $588.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $158.49 Typical High $234.42 | Professional | 80 · Assistant surgeon | $125.89 | $158.49 | $234.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $89.13 Median $109.65 Typical High $165.96 | Professional | 81 · Minimal assistant surgeon | $89.13 | $109.65 | $165.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $89.13 Median $109.65 Typical High $165.96 | Professional | 82 · Assistant surgeon, no resident | $89.13 | $109.65 | $165.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $109.65 Typical High $165.96 | Professional | AS · PA/NP assist | $89.13 | $109.65 | $165.96 |
Where South Carolina sits
The same service costs 3.5 times more in Alaska than in Arkansas. 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· 40th of 51
$692
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.