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 $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $17.78 Typical High $17.78 | Professional | None | $16.98 | $17.78 | $17.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $7.94 Median $14.13 Typical High $16.98 | Professional | None | $7.94 | $14.13 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $16.22 Typical High $26.92 | Professional | None | $15.49 | $16.22 | $26.92 |
Medcost Setting Professional Modifier None Typical Low $21.38 Median $22.91 Typical High $32.36 | Professional | None | $21.38 | $22.91 | $32.36 |
Medcost Setting Facility Modifier None Typical Low $15.85 Median $17.78 Typical High $46.77 | Facility | None | $15.85 | $17.78 | $46.77 |
Medcost Setting Professional Modifier None Typical Low $16.22 Median $17.38 Typical High $19.95 | Professional | None | $16.22 | $17.38 | $19.95 |
United Setting Professional Modifier None Typical Low $13.18 Median $15.49 Typical High $23.99 | Professional | None | $13.18 | $15.49 | $23.99 |
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 $8.51 Median $8.91 Typical High $8.91 | Professional | 52 · Reduced service | $8.51 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.55 Typical High $3.55 | Professional | 53 · Discontinued | $3.47 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $2.57 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.78 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.74 | $1.78 | $1.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $8.13 Median $8.71 Typical High $12.59 | Professional | 51 · Multiple procedures | $8.13 | $8.71 | $12.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.24 Median $3.47 Typical High $5.01 | Professional | 80 · Assistant surgeon | $3.24 | $3.47 | $5.01 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.29 Median $2.45 Typical High $3.47 | Professional | 81 · Minimal assistant surgeon | $2.29 | $2.45 | $3.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.29 Median $2.45 Typical High $3.47 | Professional | 82 · Assistant surgeon, no resident | $2.29 | $2.45 | $3.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.29 Median $2.45 Typical High $3.47 | Professional | AS · PA/NP assist | $2.29 | $2.45 | $3.47 |
Where South Carolina sits
The same service costs 3.2 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· 44th of 51
$16.22
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.