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 $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $302.00 | Professional | None | $269.15 | $302.00 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $309.03 | Professional | None | $281.84 | $302.00 | $309.03 |
BCBS South Carolina Setting Professional Modifier None Typical Low $245.47 Median $257.04 Typical High $302.00 | Professional | None | $245.47 | $257.04 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $436.52 | Professional | None | $229.09 | $239.88 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $537.03 | Professional | None | $302.00 | $323.59 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $245.47 Median $302.00 Typical High $812.83 | Facility | None | $245.47 | $302.00 | $812.83 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $338.84 | Professional | None | $239.88 | $257.04 | $338.84 |
Molina Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $575.44 | Professional | None | $288.40 | $371.54 | $575.44 |
United Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $363.08 | Professional | None | $199.53 | $234.42 | $363.08 |
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 $144.54 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $144.54 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $57.54 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $43.65 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $28.84 | $30.20 | $30.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $128.82 Typical High $208.93 | Professional | 51 · Multiple procedures | $120.23 | $128.82 | $208.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $51.29 Typical High $85.11 | Professional | 80 · Assistant surgeon | $47.86 | $51.29 | $85.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.11 Median $36.31 Typical High $58.88 | Professional | 81 · Minimal assistant surgeon | $33.11 | $36.31 | $58.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.11 Median $36.31 Typical High $58.88 | Professional | 82 · Assistant surgeon, no resident | $33.11 | $36.31 | $58.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $36.31 Typical High $58.88 | Professional | AS · PA/NP assist | $33.11 | $36.31 | $58.88 |
Where South Carolina sits
The same service costs 2.8 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
$288
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.