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 $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $18.20 Typical High $18.20 | Professional | None | $17.38 | $18.20 | $18.20 |
BCBS South Carolina Setting Professional Modifier None Typical Low $7.94 Median $17.78 Typical High $23.44 | Professional | None | $7.94 | $17.78 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $19.50 Typical High $29.51 | Professional | None | $18.62 | $19.50 | $29.51 |
Medcost Setting Professional Modifier None Typical Low $26.30 Median $28.18 Typical High $33.11 | Professional | None | $26.30 | $28.18 | $33.11 |
Medcost Setting Facility Modifier None Typical Low $18.20 Median $19.95 Typical High $47.86 | Facility | None | $18.20 | $19.95 | $47.86 |
Medcost Setting Professional Modifier None Typical Low $20.42 Median $20.89 Typical High $22.39 | Professional | None | $20.42 | $20.89 | $22.39 |
United Setting Professional Modifier None Typical Low $15.14 Median $18.62 Typical High $28.84 | Professional | None | $15.14 | $18.62 | $28.84 |
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 $8.71 Median $9.12 Typical High $9.12 | Professional | 52 · Reduced service | $8.71 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.63 Typical High $3.63 | Professional | 53 · Discontinued | $3.47 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $2.75 Typical High $2.75 | Professional | 55 · Aftercare only | $2.63 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.74 | $1.82 | $1.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $10.47 Median $11.22 Typical High $12.88 | Professional | 51 · Multiple procedures | $10.47 | $11.22 | $12.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.17 Median $4.47 Typical High $5.13 | Professional | 80 · Assistant surgeon | $4.17 | $4.47 | $5.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.88 Median $3.16 Typical High $3.55 | Professional | 81 · Minimal assistant surgeon | $2.88 | $3.16 | $3.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.88 Median $3.16 Typical High $3.55 | Professional | 82 · Assistant surgeon, no resident | $2.88 | $3.16 | $3.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.88 Median $3.16 Typical High $3.55 | Professional | AS · PA/NP assist | $2.88 | $3.16 | $3.55 |
Where South Carolina sits
The same service costs 3.4 times more in Alaska than in Florida. 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
$18.62
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.