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 $11.75 Typical High $11.75 | Facility | None | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $11.75 Typical High $11.75 | Professional | None | $10.96 | $11.75 | $11.75 |
Ambetter Setting Professional Modifier None Typical Low $8.91 Median $10.72 Typical High $15.85 | Professional | None | $8.91 | $10.72 | $15.85 |
BCBS South Carolina Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
BCBS South Carolina Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 29 | $11.22 | $11.22 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.30 Typical High $20.42 | Professional | None | $12.02 | $12.30 | $20.42 |
Medcost Setting Facility Modifier None Typical Low $11.75 Median $12.88 Typical High $30.90 | Facility | None | $11.75 | $12.88 | $30.90 |
Medcost Setting Professional Modifier None Typical Low $8.91 Median $9.55 Typical High $13.80 | Professional | None | $8.91 | $9.55 | $13.80 |
United Setting Professional Modifier None Typical Low $10.47 Median $12.59 Typical High $18.62 | Professional | None | $10.47 | $12.59 | $18.62 |
9 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 $5.50 Median $5.89 Typical High $5.89 | Professional | 52 · Reduced service | $5.50 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.34 Typical High $2.34 | Professional | 53 · Discontinued | $2.19 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.78 Typical High $1.78 | Professional | 55 · Aftercare only | $1.66 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.17 Typical High $1.17 | Professional | 56 · Pre-op care only | $1.10 | $1.17 | $1.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $4.47 Median $4.79 Typical High $8.32 | Professional | 51 · Multiple procedures | $4.47 | $4.79 | $8.32 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1.78 Median $1.91 Typical High $3.31 | Professional | 80 · Assistant surgeon | $1.78 | $1.91 | $3.31 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.23 Median $1.35 Typical High $2.29 | Professional | 81 · Minimal assistant surgeon | $1.23 | $1.35 | $2.29 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.23 Median $1.35 Typical High $2.29 | Professional | 82 · Assistant surgeon, no resident | $1.23 | $1.35 | $2.29 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.23 Median $1.35 Typical High $2.29 | Professional | AS · PA/NP assist | $1.23 | $1.35 | $2.29 |
Where South Carolina sits
The same service costs 2.6 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· 50th of 51
$10.00
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.