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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $52.48 | Professional | None | $48.98 | $48.98 | $52.48 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $74.13 | Professional | None | $54.95 | $54.95 | $74.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $39.81 Median $53.70 Typical High $125.89 | Facility | None | $39.81 | $53.70 | $125.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $81.28 | Professional | None | $54.95 | $54.95 | $81.28 |
Medcost Setting Facility Modifier None Typical Low $48.98 Median $53.70 Typical High $123.03 | Facility | None | $48.98 | $53.70 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $54.95 | Professional | None | $50.12 | $50.12 | $54.95 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $120.23 | Professional | None | $60.26 | $79.43 | $120.23 |
United Setting Facility Modifier None Typical Low $158.49 Median $190.55 Typical High $245.47 | Facility | None | $158.49 | $190.55 | $245.47 |
United Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $79.43 | Professional | None | $44.67 | $52.48 | $79.43 |
7 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 $24.55 Median $24.55 Typical High $25.70 | Professional | 52 · Reduced service | $24.55 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $10.23 | Professional | 53 · Discontinued | $9.77 | $9.77 | $10.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | 51 · Multiple procedures | $24.55 | $24.55 | $33.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.00 Median $10.00 Typical High $13.80 | Professional | 80 · Assistant surgeon | $10.00 | $10.00 | $13.80 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.92 Median $6.92 Typical High $9.55 | Professional | 81 · Minimal assistant surgeon | $6.92 | $6.92 | $9.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.92 Median $6.92 Typical High $9.55 | Professional | 82 · Assistant surgeon, no resident | $6.92 | $6.92 | $9.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.92 Median $6.92 Typical High $9.55 | Professional | AS · PA/NP assist | $6.92 | $6.92 | $9.55 |
Where South Carolina sits
The same service costs 2.6 times more in Nebraska 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· 33rd 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.