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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $91.20 Typical High $91.20 | Professional | None | $87.10 | $91.20 | $91.20 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
BCBS South Carolina Setting Professional Modifier None Typical Low $74.13 Median $128.82 Typical High $199.53 | Professional | None | $74.13 | $128.82 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $91.20 Typical High $147.91 | Professional | None | $83.18 | $91.20 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $186.21 | Professional | None | $141.25 | $162.18 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $102.33 Typical High $239.88 | Facility | None | $91.20 | $102.33 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $208.93 | Professional | None | $93.33 | $102.33 | $208.93 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $85.11 Typical High $131.83 | Professional | None | $66.07 | $85.11 | $131.83 |
United Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $138.04 | Professional | None | $75.86 | $89.13 | $138.04 |
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 $43.65 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $43.65 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $17.38 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $13.18 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.71 | $9.12 | $9.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $46.77 Median $63.10 Typical High $104.71 | Professional | 51 · Multiple procedures | $46.77 | $63.10 | $104.71 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.62 Median $25.70 Typical High $42.66 | Professional | 80 · Assistant surgeon | $18.62 | $25.70 | $42.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.18 Median $17.78 Typical High $29.51 | Professional | 81 · Minimal assistant surgeon | $13.18 | $17.78 | $29.51 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.18 Median $17.78 Typical High $29.51 | Professional | 82 · Assistant surgeon, no resident | $13.18 | $17.78 | $29.51 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.18 Median $17.78 Typical High $29.51 | Professional | AS · PA/NP assist | $13.18 | $17.78 | $29.51 |
Where South Carolina sits
The same service costs 3.1 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· 40th of 51
$91.20
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.