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 $33.11 Median $33.11 Typical High $102.33 | Facility | None | $33.11 | $33.11 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $61.66 Typical High $102.33 | Professional | None | $33.11 | $61.66 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.60 Median $22.91 Typical High $51.29 | Professional | 52 · Reduced service | $16.60 | $22.91 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $12.30 Typical High $20.42 | Professional | 53 · Discontinued | $6.61 | $12.30 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $9.33 Typical High $15.49 | Professional | 55 · Aftercare only | $4.90 | $9.33 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $6.17 Typical High $10.23 | Professional | 56 · Pre-op care only | $3.31 | $6.17 | $10.23 |
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 $26.30 Median $64.57 Typical High $91.20 | Professional | None | $26.30 | $64.57 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $52.48 Typical High $66.07 | Professional | None | $28.18 | $52.48 | $66.07 |
Medcost Setting Facility Modifier None Typical Low $35.48 Median $58.88 Typical High $138.04 | Facility | None | $35.48 | $58.88 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $114.82 | Professional | None | $63.10 | $85.11 | $114.82 |
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 $26.30 Median $42.66 Typical High $89.13 | Professional | None | $26.30 | $42.66 | $89.13 |
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 $31.62 Median $42.66 Typical High $72.44 | Professional | 51 · Multiple procedures | $31.62 | $42.66 | $72.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.59 Median $16.98 Typical High $28.84 | Professional | 80 · Assistant surgeon | $12.59 | $16.98 | $28.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.91 Median $11.75 Typical High $19.95 | Professional | 81 · Minimal assistant surgeon | $8.91 | $11.75 | $19.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.91 Median $11.75 Typical High $19.95 | Professional | 82 · Assistant surgeon, no resident | $8.91 | $11.75 | $19.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.91 Median $11.75 Typical High $19.95 | Professional | AS · PA/NP assist | $8.91 | $11.75 | $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 3.5 times more in Hawaii 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· 25th of 51
$64.57
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.