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 $97.72 Median $97.72 Typical High $128.82 | Facility | None | $97.72 | $97.72 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $107.15 Typical High $128.82 | Professional | None | $93.33 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $50.12 Typical High $64.57 | Professional | 52 · Reduced service | $46.77 | $50.12 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.95 Typical High $25.70 | Professional | 53 · Discontinued | $18.62 | $19.95 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $15.14 Typical High $19.50 | Professional | 55 · Aftercare only | $14.13 | $15.14 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.00 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.33 | $10.00 | $12.88 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
BCBS South Carolina Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $147.91 | Professional | None | $75.86 | $114.82 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $128.82 | Professional | None | $87.10 | $107.15 | $128.82 |
Medcost Setting Facility Modifier None Typical Low $100.00 Median $128.82 Typical High $257.04 | Facility | None | $100.00 | $128.82 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $144.54 | Professional | None | $134.90 | $134.90 | $144.54 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $263.03 | Professional | None | $128.82 | $213.80 | $263.03 |
United Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $131.83 | Professional | None | $74.13 | $97.72 | $131.83 |
5 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $67.61 Median $67.61 Typical High $91.20 | Professional | 51 · Multiple procedures | $67.61 | $67.61 | $91.20 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | 80 · Assistant surgeon | $26.92 | $26.92 | $36.31 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.05 Median $19.05 Typical High $25.70 | Professional | 81 · Minimal assistant surgeon | $19.05 | $19.05 | $25.70 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.05 Median $19.05 Typical High $25.70 | Professional | 82 · Assistant surgeon, no resident | $19.05 | $19.05 | $25.70 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.05 Median $19.05 Typical High $25.70 | Professional | AS · PA/NP assist | $19.05 | $19.05 | $25.70 |
Where South Carolina sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 30th of 51
$112
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.