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 $11.75 Median $11.75 Typical High $17.38 | Facility | None | $11.75 | $11.75 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $16.60 | Professional | None | $11.75 | $11.75 | $16.60 |
Ambetter Setting Professional Modifier None Typical Low $9.12 Median $10.72 Typical High $18.20 | Professional | None | $9.12 | $10.72 | $18.20 |
BCBS South Carolina Setting Facility Modifier None Typical Low $95.50 Median $245.47 Typical High $446.68 | Facility | None | $95.50 | $245.47 | $446.68 |
BCBS South Carolina Setting Professional Modifier None Typical Low $10.72 Median $12.02 Typical High $12.88 | Professional | None | $10.72 | $12.02 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $18.62 Typical High $23.44 | Professional | None | $15.49 | $18.62 | $23.44 |
Medcost Setting Facility Modifier None Typical Low $11.75 Median $12.88 Typical High $31.62 | Facility | None | $11.75 | $12.88 | $31.62 |
Medcost Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.49 | Professional | None | $13.18 | $13.18 | $13.49 |
United Setting Facility Modifier None Typical Low $158.49 Median $190.55 Typical High $251.19 | Facility | None | $158.49 | $190.55 | $251.19 |
United Setting Professional Modifier None Typical Low $12.30 Median $15.85 Typical High $25.12 | Professional | None | $12.30 | $15.85 | $25.12 |
8 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 $5.89 Median $5.89 Typical High $6.76 | Professional | 52 · Reduced service | $5.89 | $5.89 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.34 Typical High $2.69 | Professional | 53 · Discontinued | $2.34 | $2.34 | $2.69 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 59 · Distinct service | $10.72 | $10.72 | $10.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.61 Median $6.61 Typical High $8.32 | Professional | 51 · Multiple procedures | $6.61 | $6.61 | $8.32 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.63 Median $2.63 Typical High $3.31 | Professional | 80 · Assistant surgeon | $2.63 | $2.63 | $3.31 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.86 Median $1.86 Typical High $2.34 | Professional | 81 · Minimal assistant surgeon | $1.86 | $1.86 | $2.34 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.86 Median $1.86 Typical High $2.34 | Professional | 82 · Assistant surgeon, no resident | $1.86 | $1.86 | $2.34 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.86 Median $1.86 Typical High $2.34 | Professional | AS · PA/NP assist | $1.86 | $1.86 | $2.34 |
Where South Carolina sits
The same service costs 3.0 times more in Minnesota 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· 49th of 51
$12.88
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.