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 $35.48 Median $35.48 Typical High $112.20 | Facility | None | $35.48 | $35.48 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $51.29 Typical High $112.20 | Professional | None | $33.11 | $51.29 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
BCBS South Carolina Setting Facility Modifier None Typical Low $331.13 Median $537.03 Typical High $1,000.00 | Facility | None | $331.13 | $537.03 | $1,000.00 |
BCBS South Carolina Setting Professional Modifier None Typical Low $26.30 Median $61.66 Typical High $123.03 | Professional | None | $26.30 | $61.66 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $57.54 Typical High $141.25 | Professional | None | $26.92 | $57.54 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Medcost Setting Facility Modifier None Typical Low $35.48 Median $67.61 Typical High $151.36 | Facility | None | $35.48 | $67.61 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $56.23 Median $83.18 Typical High $177.83 | Professional | None | $56.23 | $83.18 | $177.83 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $251.19 | Professional | None | $131.83 | $173.78 | $251.19 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,454.71 | Facility | None | $1,584.89 | $1,905.46 | $2,454.71 |
United Setting Professional Modifier None Typical Low $30.90 Median $53.70 Typical High $125.89 | Professional | None | $30.90 | $53.70 | $125.89 |
8 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 $16.60 Median $21.88 Typical High $56.23 | Professional | 52 · Reduced service | $16.60 | $21.88 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $8.71 Typical High $22.39 | Professional | 53 · Discontinued | $6.76 | $8.71 | $22.39 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $85.11 Median $125.89 Typical High $295.12 | Professional | 50 · Both sides | $85.11 | $125.89 | $295.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $28.18 Median $41.69 Typical High $97.72 | Professional | 51 · Multiple procedures | $28.18 | $41.69 | $97.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.22 Median $16.60 Typical High $38.90 | Professional | 80 · Assistant surgeon | $11.22 | $16.60 | $38.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.94 Median $11.75 Typical High $27.54 | Professional | 81 · Minimal assistant surgeon | $7.94 | $11.75 | $27.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.94 Median $11.75 Typical High $27.54 | Professional | 82 · Assistant surgeon, no resident | $7.94 | $11.75 | $27.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.94 Median $11.75 Typical High $27.54 | Professional | AS · PA/NP assist | $7.94 | $11.75 | $27.54 |
Where South Carolina sits
The same service costs 4.2 times more in Washington than in Maryland. 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· 19th of 51
$75.86
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.