How much rates vary
Facilitymedian $162 · 10th to 90th $25 to $355Professionalmedian $36 · 10th to 90th $18 to $51
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 $18.20 Median $32.36 Typical High $44.67 | Facility | None | $18.20 | $32.36 | $44.67 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $12.30 Median $12.88 Typical High $21.38 | Facility | 52 · Reduced service | $12.30 | $12.88 | $21.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.90 Median $5.13 Typical High $8.71 | Facility | 53 · Discontinued | $4.90 | $5.13 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $32.36 Typical High $43.65 | Professional | None | $18.20 | $32.36 | $43.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $16.98 Typical High $21.38 | Professional | 52 · Reduced service | $12.30 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $6.76 Typical High $8.71 | Professional | 53 · Discontinued | $4.90 | $6.76 | $8.71 |
Ambetter Setting Professional Modifier None Typical Low $17.38 Median $39.81 Typical High $41.69 | Professional | None | $17.38 | $39.81 | $41.69 |
BCBS South Carolina Setting Facility Modifier None Typical Low $114.82 Median $162.18 Typical High $380.19 | Facility | None | $114.82 | $162.18 | $380.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $42.66 | Professional | None | $39.81 | $39.81 | $42.66 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $20.89 Median $39.81 Typical High $42.66 | Professional | 29 | $20.89 | $39.81 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $47.86 Typical High $47.86 | Professional | None | $30.20 | $47.86 | $47.86 |
Medcost Setting Facility Modifier None Typical Low $25.12 Median $43.65 Typical High $64.57 | Facility | None | $25.12 | $43.65 | $64.57 |
Medcost Setting Professional Modifier None Typical Low $34.67 Median $38.02 Typical High $53.70 | Professional | None | $34.67 | $38.02 | $53.70 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $125.89 | Professional | None | $63.10 | $79.43 | $125.89 |
United Setting Facility Modifier None Typical Low $562.34 Median $676.08 Typical High $891.25 | Facility | None | $562.34 | $676.08 | $891.25 |
United Setting Professional Modifier None Typical Low $24.55 Median $40.74 Typical High $63.10 | Professional | None | $24.55 | $40.74 | $63.10 |
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 Facility Modifier AF · Specialist physician Typical Low $24.55 Median $24.55 Typical High $43.65 | Facility | AF · Specialist physician | $24.55 | $24.55 | $43.65 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $18.20 Median $18.20 Typical High $32.36 | Facility | HO · Master's level | $18.20 | $18.20 | $32.36 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $20.89 Median $20.89 Typical High $36.31 | Facility | TD · Registered nurse | $20.89 | $20.89 | $36.31 |
Ambetter Setting Professional Modifier HO · Master's level Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | HO · Master's level | $41.69 | $41.69 | $41.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $17.38 Median $19.05 Typical High $30.20 | Professional | 51 · Multiple procedures | $17.38 | $19.05 | $30.20 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.92 Median $7.76 Typical High $12.02 | Professional | 80 · Assistant surgeon | $6.92 | $7.76 | $12.02 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.90 Median $5.37 Typical High $8.51 | Professional | 81 · Minimal assistant surgeon | $4.90 | $5.37 | $8.51 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.90 Median $5.37 Typical High $8.51 | Professional | 82 · Assistant surgeon, no resident | $4.90 | $5.37 | $8.51 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.90 Median $5.37 Typical High $8.51 | Professional | AS · PA/NP assist | $4.90 | $5.37 | $8.51 |
Where South Carolina sits
The same service costs 2.3 times more in Hawaii than in Washington, DC. 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
$36.31
HI $63.10DC $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.