How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $61.66 Median $70.79 Typical High $83.18 | Facility | None | $61.66 | $70.79 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $83.18 Typical High $158.49 | Professional | None | $61.66 | $83.18 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $158.49 | Professional | None | $95.50 | $123.03 | $158.49 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $83.18 Median $91.20 Typical High $158.49 | Professional | 29 | $83.18 | $91.20 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $194.98 | Professional | None | $117.49 | $128.82 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $239.88 | Professional | None | $165.96 | $165.96 | $239.88 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $112.20 Typical High $269.15 | Facility | None | $83.18 | $112.20 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $169.82 | Professional | None | $114.82 | $151.36 | $169.82 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $91.20 Typical High $131.83 | Professional | None | $69.18 | $91.20 | $131.83 |
United Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $213.80 | Professional | None | $112.20 | $134.90 | $213.80 |
10 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 $41.69 Median $41.69 Typical High $63.10 | Professional | 52 · Reduced service | $41.69 | $41.69 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $19.05 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $12.59 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $120.23 Median $120.23 Typical High $186.21 | Professional | 25 · Same-day visit | $120.23 | $120.23 | $186.21 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | GC · Resident with teaching physician | $158.49 | $158.49 | $158.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $77.62 Typical High $97.72 | Professional | 51 · Multiple procedures | $69.18 | $77.62 | $97.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $27.54 Median $30.90 Typical High $38.90 | Professional | 80 · Assistant surgeon | $27.54 | $30.90 | $38.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.05 Median $21.88 Typical High $26.92 | Professional | 81 · Minimal assistant surgeon | $19.05 | $21.88 | $26.92 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.05 Median $21.88 Typical High $26.92 | Professional | 82 · Assistant surgeon, no resident | $19.05 | $21.88 | $26.92 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.05 Median $21.88 Typical High $26.92 | Professional | AS · PA/NP assist | $19.05 | $21.88 | $26.92 |
Where South Carolina sits
The same service costs 2.0 times more in Alaska 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· 40th of 51
$117
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.