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 $15.85 Median $15.85 Typical High $24.55 | Facility | None | $15.85 | $15.85 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $15.85 Typical High $15.85 | Professional | None | $15.49 | $15.85 | $15.85 |
Ambetter Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $25.12 | Professional | None | $22.39 | $22.39 | $25.12 |
BCBS South Carolina Setting Facility Modifier None Typical Low $19.95 Median $30.20 Typical High $72.44 | Facility | None | $19.95 | $30.20 | $72.44 |
BCBS South Carolina Setting Professional Modifier None Typical Low $14.13 Median $15.49 Typical High $18.20 | Professional | None | $14.13 | $15.49 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Medcost Setting Professional Modifier None Typical Low $21.38 Median $26.92 Typical High $27.54 | Professional | None | $21.38 | $26.92 | $27.54 |
Medcost Setting Facility Modifier None Typical Low $15.49 Median $16.22 Typical High $21.38 | Facility | None | $15.49 | $16.22 | $21.38 |
Medcost Setting Professional Modifier None Typical Low $11.48 Median $17.78 Typical High $21.38 | Professional | None | $11.48 | $17.78 | $21.38 |
United Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $17.78 | Facility | None | $15.85 | $15.85 | $17.78 |
United Setting Professional Modifier None Typical Low $12.02 Median $15.14 Typical High $21.88 | Professional | None | $12.02 | $15.14 | $21.88 |
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 $7.76 Median $7.94 Typical High $7.94 | Professional | 52 · Reduced service | $7.76 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.16 Typical High $3.16 | Professional | 53 · Discontinued | $3.09 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.34 Typical High $2.34 | Professional | 55 · Aftercare only | $2.29 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.58 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.55 | $1.58 | $1.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.75 Median $8.91 Typical High $13.80 | Professional | 51 · Multiple procedures | $5.75 | $8.91 | $13.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.34 Median $3.63 Typical High $5.50 | Professional | 80 · Assistant surgeon | $2.34 | $3.63 | $5.50 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.62 Median $2.51 Typical High $3.89 | Professional | 81 · Minimal assistant surgeon | $1.62 | $2.51 | $3.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.62 Median $2.51 Typical High $3.89 | Professional | 82 · Assistant surgeon, no resident | $1.62 | $2.51 | $3.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.62 Median $2.51 Typical High $3.89 | Professional | AS · PA/NP assist | $1.62 | $2.51 | $3.89 |
Where South Carolina sits
The same service costs 2.8 times more in Alaska than in Louisiana. 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· 38th of 51
$15.49
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.