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 $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $34.67 Typical High $34.67 | Professional | None | $30.20 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $17.38 Typical High $17.38 | Professional | 52 · Reduced service | $15.49 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.92 Typical High $6.92 | Professional | 53 · Discontinued | $6.31 | $6.92 | $6.92 |
Ambetter Setting Professional Modifier None Typical Low $19.95 Median $34.67 Typical High $45.71 | Professional | None | $19.95 | $34.67 | $45.71 |
BCBS South Carolina Setting Facility Modifier None Typical Low $74.13 Median $128.82 Typical High $218.78 | Facility | None | $74.13 | $128.82 | $218.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $19.05 Median $21.88 Typical High $37.15 | Professional | None | $19.05 | $21.88 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $32.36 | Professional | None | $14.79 | $14.79 | $32.36 |
Medcost Setting Facility Modifier None Typical Low $15.49 Median $35.48 Typical High $100.00 | Facility | None | $15.49 | $35.48 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $15.85 Median $21.38 Typical High $38.90 | Professional | None | $15.85 | $21.38 | $38.90 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $40.74 Typical High $61.66 | Professional | None | $30.90 | $40.74 | $61.66 |
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 $24.55 Typical High $32.36 | Professional | None | $17.38 | $24.55 | $32.36 |
5 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 $7.94 Median $10.72 Typical High $24.55 | Professional | 51 · Multiple procedures | $7.94 | $10.72 | $24.55 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.24 Median $4.27 Typical High $9.77 | Professional | 80 · Assistant surgeon | $3.24 | $4.27 | $9.77 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.24 Median $3.02 Typical High $6.92 | Professional | 81 · Minimal assistant surgeon | $2.24 | $3.02 | $6.92 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.24 Median $3.02 Typical High $6.92 | Professional | 82 · Assistant surgeon, no resident | $2.24 | $3.02 | $6.92 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.24 Median $3.02 Typical High $6.92 | Professional | AS · PA/NP assist | $2.24 | $3.02 | $6.92 |
Where South Carolina sits
The same service costs 2.9 times more in North Dakota than in Kentucky. 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· 50th of 51
$26.30
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.