How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $69.18 Median $199.53 Typical High $21,877.62 | Facility | None | $69.18 | $199.53 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $158.49 Typical High $199.53 | Professional | None | $69.18 | $158.49 | $199.53 |
BCBS South Carolina Setting Professional Modifier None Typical Low $52.48 Median $177.83 Typical High $213.80 | Professional | None | $52.48 | $177.83 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $154.88 Typical High $281.84 | Professional | None | $67.61 | $154.88 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $141.25 Typical High $269.15 | Facility | None | $70.79 | $141.25 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $269.15 | Professional | None | $158.49 | $181.97 | $269.15 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $371.54 | Professional | None | $199.53 | $263.03 | $371.54 |
United Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $58.88 | Facility | None | $53.70 | $53.70 | $58.88 |
United Setting Professional Modifier None Typical Low $66.07 Median $147.91 Typical High $275.42 | Professional | None | $66.07 | $147.91 | $275.42 |
10 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $63.10 Typical High $97.72 | Professional | 52 · Reduced service | $34.67 | $63.10 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $25.70 Typical High $39.81 | Professional | 53 · Discontinued | $13.80 | $25.70 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $95.50 Typical High $147.91 | Professional | 54 · Surgery only | $51.29 | $95.50 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $19.05 Typical High $29.51 | Professional | 55 · Aftercare only | $10.23 | $19.05 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $12.88 Typical High $19.95 | Professional | 56 · Pre-op care only | $6.92 | $12.88 | $19.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $79.43 Median $91.20 Typical High $190.55 | Professional | 51 · Multiple procedures | $79.43 | $91.20 | $190.55 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $36.31 Typical High $75.86 | Professional | 80 · Assistant surgeon | $31.62 | $36.31 | $75.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $21.88 Median $25.70 Typical High $52.48 | Professional | 81 · Minimal assistant surgeon | $21.88 | $25.70 | $52.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.88 Median $25.70 Typical High $52.48 | Professional | 82 · Assistant surgeon, no resident | $21.88 | $25.70 | $52.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $21.88 Median $25.70 Typical High $52.48 | Professional | AS · PA/NP assist | $21.88 | $25.70 | $52.48 |
Where South Carolina sits
The same service costs 2.9 times more in Washington 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· 17th of 51
$186
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.