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 $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $794.33 | Professional | None | $741.31 | $794.33 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
BCBS South Carolina Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $776.25 | Professional | None | $457.09 | $512.86 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,148.15 | Professional | None | $645.65 | $660.69 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,445.44 | Professional | None | $891.25 | $954.99 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $660.69 Median $794.33 Typical High $2,137.96 | Facility | None | $660.69 | $794.33 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $891.25 | Professional | None | $676.08 | $724.44 | $891.25 |
Molina Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,445.44 | Professional | None | $741.31 | $933.25 | $1,445.44 |
United Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $1,000.00 | Professional | None | $537.03 | $630.96 | $1,000.00 |
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 $380.19 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $380.19 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $151.36 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $79.43 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $338.84 Median $363.08 Typical High $562.34 | Professional | 51 · Multiple procedures | $338.84 | $363.08 | $562.34 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $144.54 Typical High $223.87 | Professional | 80 · Assistant surgeon | $134.90 | $144.54 | $223.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $93.33 Median $102.33 Typical High $154.88 | Professional | 81 · Minimal assistant surgeon | $93.33 | $102.33 | $154.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $93.33 Median $102.33 Typical High $154.88 | Professional | 82 · Assistant surgeon, no resident | $93.33 | $102.33 | $154.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $102.33 Typical High $154.88 | Professional | AS · PA/NP assist | $93.33 | $102.33 | $154.88 |
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· 38th of 51
$741
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.