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 $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $22.39 Typical High $22.39 | Professional | None | $21.38 | $22.39 | $22.39 |
BCBS South Carolina Setting Facility Modifier None Typical Low $186.21 Median $323.59 Typical High $549.54 | Facility | None | $186.21 | $323.59 | $549.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $17.78 Median $19.95 Typical High $19.95 | Professional | None | $17.78 | $19.95 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $33.88 Typical High $45.71 | Professional | None | $23.99 | $33.88 | $45.71 |
Medcost Setting Facility Modifier None Typical Low $20.42 Median $24.55 Typical High $58.88 | Facility | None | $20.42 | $24.55 | $58.88 |
Medcost Setting Professional Modifier None Typical Low $19.50 Median $25.12 Typical High $28.84 | Professional | None | $19.50 | $25.12 | $28.84 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,445.44 | Facility | None | $912.01 | $1,096.48 | $1,445.44 |
United Setting Professional Modifier None Typical Low $19.50 Median $22.91 Typical High $37.15 | Professional | None | $19.50 | $22.91 | $37.15 |
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 $10.72 Median $11.22 Typical High $11.22 | Professional | 52 · Reduced service | $10.72 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.47 Typical High $4.47 | Professional | 53 · Discontinued | $4.27 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $3.24 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.24 Typical High $2.24 | Professional | 56 · Pre-op care only | $2.14 | $2.24 | $2.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $10.72 Median $12.59 Typical High $19.50 | Professional | 51 · Multiple procedures | $10.72 | $12.59 | $19.50 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.27 Median $5.01 Typical High $7.76 | Professional | 80 · Assistant surgeon | $4.27 | $5.01 | $7.76 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.95 Median $3.47 Typical High $5.37 | Professional | 81 · Minimal assistant surgeon | $2.95 | $3.47 | $5.37 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.95 Median $3.47 Typical High $5.37 | Professional | 82 · Assistant surgeon, no resident | $2.95 | $3.47 | $5.37 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.95 Median $3.47 Typical High $5.37 | Professional | AS · PA/NP assist | $2.95 | $3.47 | $5.37 |
Where South Carolina sits
The same service costs 2.8 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· 39th of 51
$22.39
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.