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 $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $10.96 | Professional | None | $8.71 | $8.71 | $10.96 |
BCBS South Carolina Setting Facility Modifier None Typical Low $18.62 Median $22.91 Typical High $69.18 | Facility | None | $18.62 | $22.91 | $69.18 |
BCBS South Carolina Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.80 | Professional | None | $13.18 | $13.18 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $10.96 Median $18.62 Typical High $23.99 | Facility | None | $10.96 | $18.62 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Medcost Setting Facility Modifier None Typical Low $8.71 Median $10.47 Typical High $11.75 | Facility | None | $8.71 | $10.47 | $11.75 |
Medcost Setting Professional Modifier None Typical Low $0.33 Median $0.34 Typical High $12.59 | Professional | None | $0.33 | $0.34 | $12.59 |
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 Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $44.67 | Facility | None | $20.89 | $20.89 | $44.67 |
United Setting Professional Modifier None Typical Low $5.75 Median $6.92 Typical High $8.71 | Professional | None | $5.75 | $6.92 | $8.71 |
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 $4.37 Median $4.37 Typical High $5.50 | Professional | 52 · Reduced service | $4.37 | $4.37 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.78 Median $1.78 Typical High $2.19 | Professional | 53 · Discontinued | $1.78 | $1.78 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.32 Median $1.32 Typical High $1.62 | Professional | 55 · Aftercare only | $1.32 | $1.32 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.87 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.87 | $0.87 | $1.10 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.16 Median $0.17 Typical High $7.76 | Professional | 51 · Multiple procedures | $0.16 | $0.17 | $7.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $0.07 Median $0.07 Typical High $3.16 | Professional | 80 · Assistant surgeon | $0.07 | $0.07 | $3.16 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.05 Median $0.05 Typical High $2.19 | Professional | 81 · Minimal assistant surgeon | $0.05 | $0.05 | $2.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.05 Median $0.05 Typical High $2.19 | Professional | 82 · Assistant surgeon, no resident | $0.05 | $0.05 | $2.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $0.05 Median $0.05 Typical High $2.19 | Professional | AS · PA/NP assist | $0.05 | $0.05 | $2.19 |
Where South Carolina sits
The same service costs 46.8 times more in New York than in Arkansas. 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· 45th of 51
$8.71
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.