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 $37.15 Median $102.33 Typical High $9,772.37 | Facility | None | $37.15 | $102.33 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $69.18 Typical High $102.33 | Professional | None | $26.92 | $69.18 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $33.88 Median $56.23 Typical High $75.86 | Professional | None | $33.88 | $56.23 | $75.86 |
BCBS South Carolina Setting Facility Modifier None Typical Low $154.88 Median $316.23 Typical High $630.96 | Facility | None | $154.88 | $316.23 | $630.96 |
BCBS South Carolina Setting Professional Modifier None Typical Low $11.22 Median $30.20 Typical High $95.50 | Professional | None | $11.22 | $30.20 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $39.81 Typical High $79.43 | Professional | None | $20.42 | $39.81 | $79.43 |
Medcost Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Medcost Setting Facility Modifier None Typical Low $24.55 Median $75.86 Typical High $138.04 | Facility | None | $24.55 | $75.86 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $75.86 Typical High $114.82 | Professional | None | $50.12 | $75.86 | $114.82 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $169.82 | Professional | None | $95.50 | $117.49 | $169.82 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $23.44 Median $51.29 Typical High $91.20 | Professional | None | $23.44 | $51.29 | $91.20 |
8 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 54 · Surgery only Typical Low $27.54 Median $28.84 Typical High $75.86 | Professional | 54 · Surgery only | $27.54 | $28.84 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.75 Typical High $15.14 | Professional | 55 · Aftercare only | $5.50 | $5.75 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.89 Typical High $10.23 | Professional | 56 · Pre-op care only | $3.72 | $3.89 | $10.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $24.55 Median $38.02 Typical High $70.79 | Professional | 51 · Multiple procedures | $24.55 | $38.02 | $70.79 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.00 Median $15.14 Typical High $28.18 | Professional | 80 · Assistant surgeon | $10.00 | $15.14 | $28.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.92 Median $10.72 Typical High $19.95 | Professional | 81 · Minimal assistant surgeon | $6.92 | $10.72 | $19.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.92 Median $10.72 Typical High $19.95 | Professional | 82 · Assistant surgeon, no resident | $6.92 | $10.72 | $19.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.92 Median $10.72 Typical High $19.95 | Professional | AS · PA/NP assist | $6.92 | $10.72 | $19.95 |
Where South Carolina sits
The same service costs 2.8 times more in Alaska than in Kentucky. 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· 50th of 51
$54.95
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.