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 Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $190.55 | Professional | None | $151.36 | $151.36 | $190.55 |
BCBS South Carolina Setting Facility Modifier None Typical Low $251.19 Median $446.68 Typical High $776.25 | Facility | None | $251.19 | $446.68 | $776.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $218.78 | Professional | None | $104.71 | $125.89 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $199.53 | Professional | None | $144.54 | $194.98 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $194.98 Typical High $371.54 | Facility | None | $144.54 | $194.98 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $363.08 | Professional | None | $114.82 | $199.53 | $363.08 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $245.47 | Professional | None | $123.03 | $162.18 | $245.47 |
United Setting Facility Modifier None Typical Low $398.11 Median $489.78 Typical High $630.96 | Facility | None | $398.11 | $489.78 | $630.96 |
United Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $331.13 | Professional | None | $128.82 | $190.55 | $331.13 |
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 Facility Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | 53 · Discontinued | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | 52 · Reduced service | $72.44 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $30.20 | Professional | 53 · Discontinued | $28.84 | $28.84 | $30.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $100.00 Typical High $181.97 | Professional | 51 · Multiple procedures | $57.54 | $100.00 | $181.97 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $23.44 Median $40.74 Typical High $72.44 | Professional | 80 · Assistant surgeon | $23.44 | $40.74 | $72.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.22 Median $28.18 Typical High $50.12 | Professional | 81 · Minimal assistant surgeon | $16.22 | $28.18 | $50.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.22 Median $28.18 Typical High $50.12 | Professional | 82 · Assistant surgeon, no resident | $16.22 | $28.18 | $50.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.22 Median $28.18 Typical High $50.12 | Professional | AS · PA/NP assist | $16.22 | $28.18 | $50.12 |
Where South Carolina sits
The same service costs 5.0 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· 37th of 51
$178
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.