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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | None | $204.17 | $204.17 | $234.42 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $147.91 | Professional | None | $117.49 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $223.87 Typical High $309.03 | Facility | None | $144.54 | $223.87 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medcost Setting Facility Modifier None Typical Low $131.83 Median $204.17 Typical High $275.42 | Facility | None | $131.83 | $204.17 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $354.81 | Professional | None | $239.88 | $239.88 | $354.81 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $245.47 | Professional | None | $120.23 | $169.82 | $245.47 |
United Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | None | $107.15 | $125.89 | $125.89 |
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 $100.00 Median $102.33 Typical High $117.49 | Professional | 52 · Reduced service | $100.00 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $46.77 | Professional | 53 · Discontinued | $40.74 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $35.48 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $23.44 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $23.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $120.23 Typical High $251.19 | Professional | 51 · Multiple procedures | $120.23 | $120.23 | $251.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $47.86 Typical High $100.00 | Professional | 80 · Assistant surgeon | $47.86 | $47.86 | $100.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.11 Median $33.11 Typical High $69.18 | Professional | 81 · Minimal assistant surgeon | $33.11 | $33.11 | $69.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.11 Median $33.11 Typical High $69.18 | Professional | 82 · Assistant surgeon, no resident | $33.11 | $33.11 | $69.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $33.11 Typical High $69.18 | Professional | AS · PA/NP assist | $33.11 | $33.11 | $69.18 |
Where South Carolina sits
The same service costs 2.9 times more in Alaska than in North Carolina. 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
$148
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.