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 $21.88 Median $21.88 Typical High $83.18 | Facility | None | $21.88 | $21.88 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $30.90 Typical High $83.18 | Professional | None | $21.38 | $30.90 | $83.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.72 Median $15.49 Typical High $41.69 | Professional | 52 · Reduced service | $10.72 | $15.49 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $6.17 Typical High $16.60 | Professional | 53 · Discontinued | $4.27 | $6.17 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $4.57 Typical High $12.30 | Professional | 55 · Aftercare only | $3.24 | $4.57 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $4.79 Typical High $8.32 | Professional | 56 · Pre-op care only | $2.19 | $4.79 | $8.32 |
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 $17.38 Median $48.98 Typical High $74.13 | Professional | None | $17.38 | $48.98 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $41.69 Typical High $52.48 | Professional | None | $17.78 | $41.69 | $52.48 |
Medcost Setting Facility Modifier None Typical Low $22.39 Median $48.98 Typical High $112.20 | Facility | None | $22.39 | $48.98 | $112.20 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $63.10 Typical High $93.33 | Professional | None | $52.48 | $63.10 | $93.33 |
Molina Setting Professional Modifier None Typical Low $61.66 Median $102.33 Typical High $131.83 | Professional | None | $61.66 | $102.33 | $131.83 |
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 $17.38 Median $30.20 Typical High $72.44 | Professional | None | $17.38 | $30.20 | $72.44 |
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 $25.70 Median $31.62 Typical High $57.54 | Professional | 51 · Multiple procedures | $25.70 | $31.62 | $57.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.47 Median $12.59 Typical High $22.91 | Professional | 80 · Assistant surgeon | $10.47 | $12.59 | $22.91 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.24 Median $8.91 Typical High $16.22 | Professional | 81 · Minimal assistant surgeon | $7.24 | $8.91 | $16.22 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.24 Median $8.91 Typical High $16.22 | Professional | 82 · Assistant surgeon, no resident | $7.24 | $8.91 | $16.22 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.24 Median $8.91 Typical High $16.22 | Professional | AS · PA/NP assist | $7.24 | $8.91 | $16.22 |
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 4.4 times more in Hawaii 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· 25th of 51
$48.98
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.