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 $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $24.55 Typical High $27.54 | Professional | None | $23.99 | $24.55 | $27.54 |
Ambetter Setting Professional Modifier None Typical Low $20.89 Median $30.90 Typical High $40.74 | Professional | None | $20.89 | $30.90 | $40.74 |
BCBS South Carolina Setting Professional Modifier None Typical Low $22.39 Median $25.12 Typical High $25.70 | Professional | None | $22.39 | $25.12 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $32.36 Typical High $40.74 | Professional | None | $26.92 | $32.36 | $40.74 |
Medcost Setting Facility Modifier None Typical Low $24.55 Median $26.92 Typical High $63.10 | Facility | None | $24.55 | $26.92 | $63.10 |
Medcost Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
United Setting Professional Modifier None Typical Low $20.89 Median $26.92 Typical High $43.65 | Professional | None | $20.89 | $26.92 | $43.65 |
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 $12.02 Median $12.02 Typical High $12.02 | Professional | 52 · Reduced service | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 53 · Discontinued | $4.79 | $4.79 | $4.79 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 59 · Distinct service | $22.39 | $22.39 | $22.39 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $13.49 Median $13.49 Typical High $16.98 | Professional | 51 · Multiple procedures | $13.49 | $13.49 | $16.98 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.50 Median $5.50 Typical High $6.76 | Professional | 80 · Assistant surgeon | $5.50 | $5.50 | $6.76 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.80 Median $3.80 Typical High $4.79 | Professional | 81 · Minimal assistant surgeon | $3.80 | $3.80 | $4.79 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.80 Median $3.80 Typical High $4.79 | Professional | 82 · Assistant surgeon, no resident | $3.80 | $3.80 | $4.79 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.80 Median $3.80 Typical High $4.79 | Professional | AS · PA/NP assist | $3.80 | $3.80 | $4.79 |
Where South Carolina sits
The same service costs 2.8 times more in Alaska 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· 38th of 51
$25.70
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.