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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $8.51 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $288.40 | Professional | None | $245.47 | $288.40 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $85.11 Median $93.33 Typical High $109.65 | Facility | None | $85.11 | $93.33 | $109.65 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $95.50 | Professional | None | $79.43 | $89.13 | $95.50 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
6 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 |
|---|---|---|---|---|---|
BCBS South Carolina Setting Professional Modifier 29 Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 29 | $120.23 | $120.23 | $120.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $39.81 Median $44.67 Typical High $47.86 | Professional | 51 · Multiple procedures | $39.81 | $44.67 | $47.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.85 Median $18.20 Typical High $19.05 | Professional | 80 · Assistant surgeon | $15.85 | $18.20 | $19.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.96 Median $12.59 Typical High $13.49 | Professional | 81 · Minimal assistant surgeon | $10.96 | $12.59 | $13.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.96 Median $12.59 Typical High $13.49 | Professional | 82 · Assistant surgeon, no resident | $10.96 | $12.59 | $13.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.96 Median $12.59 Typical High $13.49 | Professional | AS · PA/NP assist | $10.96 | $12.59 | $13.49 |
Where South Carolina sits
The same service costs 6.6 times more in Illinois than in Missouri. 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· 20th of 51
$85.11
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.