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 $63.10 Median $63.10 Typical High $123.03 | Facility | None | $63.10 | $63.10 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $123.03 | Professional | None | $61.66 | $79.43 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $39.81 Typical High $61.66 | Professional | 52 · Reduced service | $30.90 | $39.81 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $16.22 Typical High $24.55 | Professional | 53 · Discontinued | $12.59 | $16.22 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $12.02 Typical High $18.62 | Professional | 55 · Aftercare only | $9.33 | $12.02 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.94 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.17 | $7.94 | $12.30 |
BCBS South Carolina Setting Facility Modifier None Typical Low $147.91 Median $251.19 Typical High $446.68 | Facility | None | $147.91 | $251.19 | $446.68 |
BCBS South Carolina Setting Professional Modifier None Typical Low $48.98 Median $97.72 Typical High $114.82 | Professional | None | $48.98 | $97.72 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $72.44 Typical High $97.72 | Professional | None | $51.29 | $72.44 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $64.57 Median $87.10 Typical High $165.96 | Facility | None | $64.57 | $87.10 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $141.25 | Professional | None | $91.20 | $104.71 | $141.25 |
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 $35.48 Median $61.66 Typical High $114.82 | Professional | None | $35.48 | $61.66 | $114.82 |
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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $45.71 Median $52.48 Typical High $87.10 | Professional | 51 · Multiple procedures | $45.71 | $52.48 | $87.10 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.20 Median $20.89 Typical High $34.67 | Professional | 80 · Assistant surgeon | $18.20 | $20.89 | $34.67 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.88 Median $14.45 Typical High $24.55 | Professional | 81 · Minimal assistant surgeon | $12.88 | $14.45 | $24.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.88 Median $14.45 Typical High $24.55 | Professional | 82 · Assistant surgeon, no resident | $12.88 | $14.45 | $24.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.88 Median $14.45 Typical High $24.55 | Professional | AS · PA/NP assist | $12.88 | $14.45 | $24.55 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where South Carolina sits
The same service costs 2.8 times more in Alaska 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· 33rd of 51
$87.10
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.