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 $18.20 Median $18.20 Typical High $512.86 | Facility | None | $18.20 | $18.20 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $33.11 | Professional | None | $18.20 | $18.20 | $33.11 |
Ambetter Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
BCBS South Carolina Setting Facility Modifier None Typical Low $158.49 Median $257.04 Typical High $478.63 | Facility | None | $158.49 | $257.04 | $478.63 |
BCBS South Carolina Setting Professional Modifier None Typical Low $16.60 Median $54.95 Typical High $54.95 | Professional | None | $16.60 | $54.95 | $54.95 |
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 $25.12 Median $48.98 Typical High $57.54 | Professional | None | $25.12 | $48.98 | $57.54 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Medcost Setting Facility Modifier None Typical Low $18.20 Median $24.55 Typical High $47.86 | Facility | None | $18.20 | $24.55 | $47.86 |
Medcost Setting Professional Modifier None Typical Low $20.42 Median $33.88 Typical High $75.86 | Professional | None | $20.42 | $33.88 | $75.86 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $40.74 Typical High $60.26 | Professional | None | $30.90 | $40.74 | $60.26 |
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 $19.50 Median $28.18 Typical High $69.18 | Professional | None | $19.50 | $28.18 | $69.18 |
7 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 $9.12 Median $9.12 Typical High $9.33 | Professional | 52 · Reduced service | $9.12 | $9.12 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $3.72 | Professional | 53 · Discontinued | $3.63 | $3.63 | $3.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.59 Median $23.44 Typical High $38.02 | Professional | 51 · Multiple procedures | $12.59 | $23.44 | $38.02 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.01 Median $9.33 Typical High $15.14 | Professional | 80 · Assistant surgeon | $5.01 | $9.33 | $15.14 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.55 Median $6.46 Typical High $10.72 | Professional | 81 · Minimal assistant surgeon | $3.55 | $6.46 | $10.72 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.55 Median $6.46 Typical High $10.72 | Professional | 82 · Assistant surgeon, no resident | $3.55 | $6.46 | $10.72 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.55 Median $6.46 Typical High $10.72 | Professional | AS · PA/NP assist | $3.55 | $6.46 | $10.72 |
Where South Carolina sits
The same service costs 3.0 times more in Minnesota than in Pennsylvania. 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· 4th 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.