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 $131.83 Median $169.82 Typical High $223.87 | Facility | None | $131.83 | $169.82 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $281.84 | Professional | None | $131.83 | $173.78 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $338.84 | Professional | None | $186.21 | $257.04 | $338.84 |
BCBS South Carolina Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $141.25 Median $186.21 Typical High $269.15 | Professional | 29 | $141.25 | $186.21 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $363.08 | Professional | None | $190.55 | $213.80 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $389.05 | Professional | None | $275.42 | $275.42 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $173.78 Median $213.80 Typical High $575.44 | Facility | None | $173.78 | $213.80 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $281.84 | Professional | None | $229.09 | $251.19 | $281.84 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $323.59 | Professional | None | $169.82 | $218.78 | $323.59 |
United Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $363.08 | Professional | None | $186.21 | $223.87 | $363.08 |
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 52 · Reduced service Typical Low $87.10 Median $87.10 Typical High $102.33 | Professional | 52 · Reduced service | $87.10 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $30.90 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $20.42 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $20.42 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $114.82 Median $134.90 Typical High $186.21 | Professional | 51 · Multiple procedures | $114.82 | $134.90 | $186.21 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $45.71 Median $53.70 Typical High $75.86 | Professional | 80 · Assistant surgeon | $45.71 | $53.70 | $75.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $31.62 Median $38.02 Typical High $52.48 | Professional | 81 · Minimal assistant surgeon | $31.62 | $38.02 | $52.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $31.62 Median $38.02 Typical High $52.48 | Professional | 82 · Assistant surgeon, no resident | $31.62 | $38.02 | $52.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $38.02 Typical High $52.48 | Professional | AS · PA/NP assist | $31.62 | $38.02 | $52.48 |
Where South Carolina sits
The same service costs 2.4 times more in Alaska than in Utah. 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· 35th of 51
$214
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.