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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $70.79 Typical High $114.82 | Professional | None | $69.18 | $70.79 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $69.18 Typical High $102.33 | Professional | None | $64.57 | $69.18 | $102.33 |
BCBS South Carolina Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $1,513.56 | Facility | None | $436.52 | $436.52 | $1,513.56 |
BCBS South Carolina Setting Professional Modifier None Typical Low $69.18 Median $144.54 Typical High $186.21 | Professional | None | $69.18 | $144.54 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $117.49 Typical High $131.83 | Professional | None | $83.18 | $117.49 | $131.83 |
Medcost Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $89.13 Typical High $194.98 | Facility | None | $70.79 | $89.13 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $208.93 | Professional | None | $79.43 | $102.33 | $208.93 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $125.89 | Professional | None | $64.57 | $83.18 | $125.89 |
United Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $154.88 | Professional | None | $57.54 | $89.13 | $154.88 |
9 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 $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $34.67 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $13.80 | $14.13 | $14.13 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 51 · Multiple procedures | $64.57 | $64.57 | $64.57 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 59 · Distinct service | $97.72 | $97.72 | $97.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $46.77 Median $64.57 Typical High $104.71 | Professional | 51 · Multiple procedures | $46.77 | $64.57 | $104.71 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.62 Median $25.70 Typical High $41.69 | Professional | 80 · Assistant surgeon | $18.62 | $25.70 | $41.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.18 Median $18.20 Typical High $29.51 | Professional | 81 · Minimal assistant surgeon | $13.18 | $18.20 | $29.51 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.18 Median $18.20 Typical High $29.51 | Professional | 82 · Assistant surgeon, no resident | $13.18 | $18.20 | $29.51 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.18 Median $18.20 Typical High $29.51 | Professional | AS · PA/NP assist | $13.18 | $18.20 | $29.51 |
Where South Carolina sits
The same service costs 2.7 times more in Minnesota than in Florida. 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· 23rd of 51
$97.72
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.