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 $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | None | $512.86 | $537.03 | $537.03 |
BCBS South Carolina Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $549.54 | Professional | None | $467.74 | $512.86 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $776.25 | Professional | None | $457.09 | $467.74 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $977.24 | Professional | None | $616.60 | $660.69 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $537.03 Typical High $1,445.44 | Facility | None | $467.74 | $537.03 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $602.56 | Professional | None | $467.74 | $512.86 | $602.56 |
Molina Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $1,023.29 | Professional | None | $512.86 | $660.69 | $1,023.29 |
United Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $707.95 | Professional | None | $389.05 | $446.68 | $707.95 |
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 $257.04 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $257.04 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $102.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $51.29 | $53.70 | $53.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $257.04 Typical High $380.19 | Professional | 51 · Multiple procedures | $234.42 | $257.04 | $380.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $102.33 Typical High $151.36 | Professional | 80 · Assistant surgeon | $93.33 | $102.33 | $151.36 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $66.07 Median $72.44 Typical High $104.71 | Professional | 81 · Minimal assistant surgeon | $66.07 | $72.44 | $104.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $66.07 Median $72.44 Typical High $104.71 | Professional | 82 · Assistant surgeon, no resident | $66.07 | $72.44 | $104.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $72.44 Typical High $104.71 | Professional | AS · PA/NP assist | $66.07 | $72.44 | $104.71 |
Where South Carolina sits
The same service costs 3.2 times more in Alaska than in New York. 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· 39th of 51
$513
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.