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 $44.67 Median $44.67 Typical High $100.00 | Facility | None | $44.67 | $44.67 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $100.00 | Professional | None | $44.67 | $63.10 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $31.62 Typical High $50.12 | Professional | 52 · Reduced service | $22.39 | $31.62 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $12.59 Typical High $19.95 | Professional | 53 · Discontinued | $8.91 | $12.59 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $9.55 Typical High $15.14 | Professional | 55 · Aftercare only | $6.76 | $9.55 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $6.31 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.47 | $6.31 | $10.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $102.33 Median $190.55 Typical High $323.59 | Facility | None | $102.33 | $190.55 | $323.59 |
BCBS South Carolina Setting Professional Modifier None Typical Low $35.48 Median $81.28 Typical High $91.20 | Professional | None | $35.48 | $81.28 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $61.66 Typical High $77.62 | Professional | None | $36.31 | $61.66 | $77.62 |
Medcost Setting Facility Modifier None Typical Low $44.67 Median $74.13 Typical High $134.90 | Facility | None | $44.67 | $74.13 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $77.62 Median $89.13 Typical High $112.20 | Professional | None | $77.62 | $89.13 | $112.20 |
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 $30.20 Median $47.86 Typical High $91.20 | Professional | None | $30.20 | $47.86 | $91.20 |
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 $38.90 Median $44.67 Typical High $70.79 | Professional | 51 · Multiple procedures | $38.90 | $44.67 | $70.79 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.49 Median $17.78 Typical High $28.18 | Professional | 80 · Assistant surgeon | $15.49 | $17.78 | $28.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.96 Median $12.30 Typical High $19.95 | Professional | 81 · Minimal assistant surgeon | $10.96 | $12.30 | $19.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.96 Median $12.30 Typical High $19.95 | Professional | 82 · Assistant surgeon, no resident | $10.96 | $12.30 | $19.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.96 Median $12.30 Typical High $19.95 | Professional | AS · PA/NP assist | $10.96 | $12.30 | $19.95 |
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 2.5 times more in Alaska than in Washington, DC. 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· 24th of 51
$74.13
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.