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 $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $25.12 Typical High $25.12 | Professional | None | $24.55 | $25.12 | $25.12 |
Ambetter Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
BCBS South Carolina Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
BCBS South Carolina Setting Professional Modifier None Typical Low $23.99 Median $28.84 Typical High $39.81 | Professional | None | $23.99 | $28.84 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $26.30 Typical High $40.74 | Professional | None | $25.12 | $26.30 | $40.74 |
Medcost Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $45.71 | Professional | None | $37.15 | $38.90 | $45.71 |
Medcost Setting Facility Modifier None Typical Low $25.12 Median $27.54 Typical High $67.61 | Facility | None | $25.12 | $27.54 | $67.61 |
Medcost Setting Professional Modifier None Typical Low $26.30 Median $28.18 Typical High $37.15 | Professional | None | $26.30 | $28.18 | $37.15 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $42.66 Typical High $66.07 | Professional | None | $33.11 | $42.66 | $66.07 |
United Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $26.92 | Facility | None | $24.55 | $24.55 | $26.92 |
United Setting Professional Modifier None Typical Low $20.89 Median $25.12 Typical High $38.90 | Professional | None | $20.89 | $25.12 | $38.90 |
7 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 $12.30 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $12.30 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $4.90 | $5.13 | $5.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.88 Median $17.78 Typical High $18.62 | Professional | 51 · Multiple procedures | $12.88 | $17.78 | $18.62 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.25 Median $7.08 Typical High $7.41 | Professional | 80 · Assistant surgeon | $5.25 | $7.08 | $7.41 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.63 Median $5.01 Typical High $5.13 | Professional | 81 · Minimal assistant surgeon | $3.63 | $5.01 | $5.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.63 Median $5.01 Typical High $5.13 | Professional | 82 · Assistant surgeon, no resident | $3.63 | $5.01 | $5.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.63 Median $5.01 Typical High $5.13 | Professional | AS · PA/NP assist | $3.63 | $5.01 | $5.13 |
Where South Carolina sits
The same service costs 2.6 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
$26.92
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.