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 $18.62 Median $18.62 Typical High $436.52 | Facility | None | $18.62 | $18.62 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $354.81 Typical High $436.52 | Professional | None | $18.62 | $354.81 | $436.52 |
BCBS South Carolina Setting Facility Modifier None Typical Low $213.80 Median $338.84 Typical High $645.65 | Facility | None | $213.80 | $338.84 | $645.65 |
BCBS South Carolina Setting Professional Modifier None Typical Low $15.14 Median $208.93 Typical High $371.54 | Professional | None | $15.14 | $208.93 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $11.75 Median $95.50 Typical High $389.05 | Professional | None | $11.75 | $95.50 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $18.62 Median $50.12 Typical High $588.84 | Facility | None | $18.62 | $50.12 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $138.04 Typical High $489.78 | Professional | None | $134.90 | $138.04 | $489.78 |
Molina Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $660.69 | Professional | None | $363.08 | $457.09 | $660.69 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,348.96 | Facility | None | $851.14 | $1,023.29 | $1,348.96 |
United Setting Professional Modifier None Typical Low $15.14 Median $75.86 Typical High $302.00 | Professional | None | $15.14 | $75.86 | $302.00 |
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 $9.33 Median $10.00 Typical High $218.78 | Professional | 52 · Reduced service | $9.33 | $10.00 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.98 Typical High $87.10 | Professional | 53 · Discontinued | $3.72 | $3.98 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.02 Typical High $66.07 | Professional | 55 · Aftercare only | $2.82 | $3.02 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.00 Typical High $43.65 | Professional | 56 · Pre-op care only | $1.86 | $2.00 | $43.65 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $67.61 Median $69.18 Typical High $309.03 | Professional | 51 · Multiple procedures | $67.61 | $69.18 | $309.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.92 Median $27.54 Typical High $123.03 | Professional | 80 · Assistant surgeon | $26.92 | $27.54 | $123.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.05 Median $19.05 Typical High $87.10 | Professional | 81 · Minimal assistant surgeon | $19.05 | $19.05 | $87.10 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.05 Median $19.05 Typical High $87.10 | Professional | 82 · Assistant surgeon, no resident | $19.05 | $19.05 | $87.10 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.05 Median $19.05 Typical High $87.10 | Professional | AS · PA/NP assist | $19.05 | $19.05 | $87.10 |
Where South Carolina sits
The same service costs 28.2 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· 7th of 51
$309
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.