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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $69.18 Typical High $69.18 | Professional | None | $60.26 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $30.20 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $12.02 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $9.12 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.03 | $6.92 | $6.92 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
BCBS South Carolina Setting Facility Modifier None Typical Low $275.42 Median $467.74 Typical High $812.83 | Facility | None | $275.42 | $467.74 | $812.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $69.18 Median $131.83 Typical High $204.17 | Professional | None | $69.18 | $131.83 | $204.17 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 29 | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $117.49 | Professional | None | $52.48 | $52.48 | $117.49 |
Medcost Setting Facility Modifier None Typical Low $69.18 Median $75.86 Typical High $186.21 | Facility | None | $69.18 | $75.86 | $186.21 |
Medcost Setting Professional Modifier None Typical Low $41.69 Median $51.29 Typical High $77.62 | Professional | None | $41.69 | $51.29 | $77.62 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $128.82 | Professional | None | $64.57 | $95.50 | $128.82 |
United Setting Professional Modifier None Typical Low $47.86 Median $60.26 Typical High $95.50 | Professional | None | $47.86 | $60.26 | $95.50 |
5 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $20.89 Median $25.70 Typical High $47.86 | Professional | 51 · Multiple procedures | $20.89 | $25.70 | $47.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.32 Median $10.47 Typical High $19.50 | Professional | 80 · Assistant surgeon | $8.32 | $10.47 | $19.50 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.89 Median $7.24 Typical High $13.49 | Professional | 81 · Minimal assistant surgeon | $5.89 | $7.24 | $13.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.89 Median $7.24 Typical High $13.49 | Professional | 82 · Assistant surgeon, no resident | $5.89 | $7.24 | $13.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.89 Median $7.24 Typical High $13.49 | Professional | AS · PA/NP assist | $5.89 | $7.24 | $13.49 |
Where South Carolina sits
The same service costs 3.2 times more in Alaska 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· 25th of 51
$69.18
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.