How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $77.62 Median $77.62 Typical High $128.82 | Facility | None | $77.62 | $77.62 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $128.82 | Professional | None | $75.86 | $91.20 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $43.65 Typical High $64.57 | Professional | 52 · Reduced service | $38.90 | $43.65 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.18 Typical High $19.05 | Professional | 55 · Aftercare only | $11.48 | $13.18 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.71 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.76 | $8.71 | $12.88 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $120.23 Typical High $131.83 | Professional | None | $67.61 | $120.23 | $131.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $162.18 Median $281.84 Typical High $489.78 | Facility | None | $162.18 | $281.84 | $489.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $120.23 | Professional | None | $53.70 | $69.18 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $100.00 | Professional | None | $45.71 | $64.57 | $100.00 |
Medcost Setting Facility Modifier None Typical Low $77.62 Median $104.71 Typical High $208.93 | Facility | None | $77.62 | $104.71 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $144.54 | Professional | None | $60.26 | $95.50 | $144.54 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $158.49 Typical High $194.98 | Professional | None | $95.50 | $158.49 | $194.98 |
United Setting Facility Modifier None Typical Low $562.34 Median $676.08 Typical High $891.25 | Facility | None | $562.34 | $676.08 | $891.25 |
United Setting Professional Modifier None Typical Low $47.86 Median $74.13 Typical High $117.49 | Professional | None | $47.86 | $74.13 | $117.49 |
6 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $112.20 Median $120.23 Typical High $223.87 | Professional | 25 · Same-day visit | $112.20 | $120.23 | $223.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.20 Median $47.86 Typical High $89.13 | Professional | 51 · Multiple procedures | $30.20 | $47.86 | $89.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.02 Median $19.05 Typical High $35.48 | Professional | 80 · Assistant surgeon | $12.02 | $19.05 | $35.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.32 Median $13.49 Typical High $25.12 | Professional | 81 · Minimal assistant surgeon | $8.32 | $13.49 | $25.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.32 Median $13.49 Typical High $25.12 | Professional | 82 · Assistant surgeon, no resident | $8.32 | $13.49 | $25.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.32 Median $13.49 Typical High $25.12 | Professional | AS · PA/NP assist | $8.32 | $13.49 | $25.12 |
Where South Carolina sits
The same service costs 4.3 times more in Alaska than in North Carolina. 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
$77.62
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.