How much rates vary
Facilitymedian $8 · 10th to 90th $5 to $18Professionalmedian $5 · 10th to 90th $3 to $6
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 $4.57 Median $4.57 Typical High $4.57 | Facility | None | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.57 Typical High $5.25 | Professional | None | $4.47 | $4.57 | $5.25 |
Ambetter Setting Professional Modifier None Typical Low $3.72 Median $4.57 Typical High $6.46 | Professional | None | $3.72 | $4.57 | $6.46 |
BCBS South Carolina Setting Facility Modifier None Typical Low $7.76 Median $7.76 Typical High $18.20 | Facility | None | $7.76 | $7.76 | $18.20 |
BCBS South Carolina Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $4.57 Median $6.03 Typical High $6.03 | Professional | 29 | $4.57 | $6.03 | $6.03 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.09 Typical High $5.62 | Professional | None | $3.02 | $3.09 | $5.62 |
Medcost Setting Facility Modifier None Typical Low $4.57 Median $5.01 Typical High $12.02 | Facility | None | $4.57 | $5.01 | $12.02 |
Medcost Setting Professional Modifier None Typical Low $3.63 Median $4.17 Typical High $5.89 | Professional | None | $3.63 | $4.17 | $5.89 |
United Setting Facility Modifier None Typical Low $158.49 Median $190.55 Typical High $251.19 | Facility | None | $158.49 | $190.55 | $251.19 |
United Setting Professional Modifier None Typical Low $4.07 Median $5.13 Typical High $8.13 | Professional | None | $4.07 | $5.13 | $8.13 |
11 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 $2.24 Median $2.29 Typical High $2.29 | Professional | 52 · Reduced service | $2.24 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.91 Typical High $0.91 | Professional | 53 · Discontinued | $0.89 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | 55 · Aftercare only | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.46 Typical High $0.46 | Professional | 56 · Pre-op care only | $0.45 | $0.46 | $0.46 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $3.72 Median $4.57 Typical High $5.01 | Professional | 59 · Distinct service | $3.72 | $4.57 | $5.01 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | SA · Nurse practitioner | $3.89 | $3.89 | $3.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.82 Median $2.09 Typical High $3.24 | Professional | 51 · Multiple procedures | $1.82 | $2.09 | $3.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $0.72 Median $0.83 Typical High $1.29 | Professional | 80 · Assistant surgeon | $0.72 | $0.83 | $1.29 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.51 Median $0.58 Typical High $0.89 | Professional | 81 · Minimal assistant surgeon | $0.51 | $0.58 | $0.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.51 Median $0.58 Typical High $0.89 | Professional | 82 · Assistant surgeon, no resident | $0.51 | $0.58 | $0.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $0.51 Median $0.58 Typical High $0.89 | Professional | AS · PA/NP assist | $0.51 | $0.58 | $0.89 |
Where South Carolina sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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· 40th of 51
$4.57
ND $8.71NM $3.24
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.