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 $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $512.86 Typical High $512.86 | Professional | None | $501.19 | $512.86 | $512.86 |
BCBS South Carolina Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $501.19 | Professional | None | $426.58 | $457.09 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $446.68 Typical High $758.58 | Professional | None | $436.52 | $446.68 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $933.25 | Professional | None | $588.84 | $630.96 | $933.25 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $512.86 Typical High $1,380.38 | Facility | None | $446.68 | $512.86 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $575.44 | Professional | None | $446.68 | $489.78 | $575.44 |
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 $371.54 Median $426.58 Typical High $676.08 | Professional | None | $371.54 | $426.58 | $676.08 |
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 $245.47 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $245.47 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $100.00 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $50.12 | $51.29 | $51.29 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $245.47 Typical High $363.08 | Professional | 51 · Multiple procedures | $223.87 | $245.47 | $363.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $97.72 Typical High $144.54 | Professional | 80 · Assistant surgeon | $91.20 | $97.72 | $144.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $63.10 Median $69.18 Typical High $100.00 | Professional | 81 · Minimal assistant surgeon | $63.10 | $69.18 | $100.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $63.10 Median $69.18 Typical High $100.00 | Professional | 82 · Assistant surgeon, no resident | $63.10 | $69.18 | $100.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $69.18 Typical High $100.00 | Professional | AS · PA/NP assist | $63.10 | $69.18 | $100.00 |
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· 37th of 51
$501
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.