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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | None | $109.65 | $112.20 | $112.20 |
BCBS South Carolina Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $102.33 | Professional | None | $87.10 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $213.80 | Professional | None | $100.00 | $120.23 | $213.80 |
Medcost Setting Facility Modifier None Typical Low $112.20 Median $123.03 Typical High $295.12 | Facility | None | $112.20 | $123.03 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $147.91 | Professional | None | $104.71 | $134.90 | $147.91 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $190.55 | Professional | None | $100.00 | $125.89 | $190.55 |
United Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $190.55 | Professional | None | $100.00 | $120.23 | $190.55 |
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 $54.95 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $54.95 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $21.88 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $16.22 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $10.96 | $11.22 | $11.22 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $67.61 Typical High $97.72 | Professional | 51 · Multiple procedures | $57.54 | $67.61 | $97.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $22.91 Median $26.92 Typical High $38.90 | Professional | 80 · Assistant surgeon | $22.91 | $26.92 | $38.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.85 Median $19.05 Typical High $27.54 | Professional | 81 · Minimal assistant surgeon | $15.85 | $19.05 | $27.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.85 Median $19.05 Typical High $27.54 | Professional | 82 · Assistant surgeon, no resident | $15.85 | $19.05 | $27.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.85 Median $19.05 Typical High $27.54 | Professional | AS · PA/NP assist | $15.85 | $19.05 | $27.54 |
Where South Carolina sits
The same service costs 2.8 times more in Alaska than in Texas. 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· 42nd of 51
$112
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.