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 $11.75 Median $31.62 Typical High $54.95 | Facility | None | $11.75 | $31.62 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $33.11 Typical High $44.67 | Professional | None | $11.75 | $33.11 | $44.67 |
Ambetter Setting Professional Modifier None Typical Low $10.72 Median $18.20 Typical High $38.02 | Professional | None | $10.72 | $18.20 | $38.02 |
BCBS South Carolina Setting Professional Modifier None Typical Low $9.77 Median $33.88 Typical High $35.48 | Professional | None | $9.77 | $33.88 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $40.74 Typical High $61.66 | Professional | None | $13.49 | $40.74 | $61.66 |
Medcost Setting Facility Modifier None Typical Low $12.30 Median $31.62 Typical High $50.12 | Facility | None | $12.30 | $31.62 | $50.12 |
Medcost Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $56.23 | Professional | None | $41.69 | $44.67 | $56.23 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $41.69 Typical High $60.26 | Professional | None | $31.62 | $41.69 | $60.26 |
United Setting Professional Modifier None Typical Low $10.96 Median $31.62 Typical High $58.88 | Professional | None | $10.96 | $31.62 | $58.88 |
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 $11.48 Typical High $18.62 | Professional | 52 · Reduced service | $5.89 | $11.48 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $4.57 Typical High $7.41 | Professional | 53 · Discontinued | $2.40 | $4.57 | $7.41 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 59 · Distinct service | $34.67 | $34.67 | $34.67 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.39 Median $22.39 Typical High $35.48 | Professional | 51 · Multiple procedures | $22.39 | $22.39 | $35.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $9.12 Median $9.12 Typical High $14.13 | Professional | 80 · Assistant surgeon | $9.12 | $9.12 | $14.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.31 Median $6.31 Typical High $10.00 | Professional | 81 · Minimal assistant surgeon | $6.31 | $6.31 | $10.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.31 Median $6.31 Typical High $10.00 | Professional | 82 · Assistant surgeon, no resident | $6.31 | $6.31 | $10.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.31 Median $6.31 Typical High $10.00 | Professional | AS · PA/NP assist | $6.31 | $6.31 | $10.00 |
Where South Carolina sits
The same service costs 2.5 times more in Kansas than in Maryland. 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· 31st of 51
$35.48
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.