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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $63.10 | Professional | None | $53.70 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $26.92 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $10.72 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $7.94 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.37 | $6.31 | $6.31 |
BCBS South Carolina Setting Facility Modifier None Typical Low $147.91 Median $251.19 Typical High $446.68 | Facility | None | $147.91 | $251.19 | $446.68 |
BCBS South Carolina Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $60.26 | Professional | None | $47.86 | $47.86 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Medcost Setting Facility Modifier None Typical Low $23.44 Median $63.10 Typical High $169.82 | Facility | None | $23.44 | $63.10 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $70.79 | Professional | None | $42.66 | $43.65 | $70.79 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $51.29 Typical High $66.07 | Professional | None | $30.90 | $51.29 | $66.07 |
United Setting Facility Modifier None Typical Low $120.23 Median $147.91 Typical High $190.55 | Facility | None | $120.23 | $147.91 | $190.55 |
United Setting Professional Modifier None Typical Low $30.90 Median $44.67 Typical High $56.23 | Professional | None | $30.90 | $44.67 | $56.23 |
5 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $21.38 Median $21.88 Typical High $44.67 | Professional | 51 · Multiple procedures | $21.38 | $21.88 | $44.67 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.51 Median $8.71 Typical High $17.78 | Professional | 80 · Assistant surgeon | $8.51 | $8.71 | $17.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.89 Median $6.17 Typical High $12.59 | Professional | 81 · Minimal assistant surgeon | $5.89 | $6.17 | $12.59 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.89 Median $6.17 Typical High $12.59 | Professional | 82 · Assistant surgeon, no resident | $5.89 | $6.17 | $12.59 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.89 Median $6.17 Typical High $12.59 | Professional | AS · PA/NP assist | $5.89 | $6.17 | $12.59 |
Where South Carolina sits
The same service costs 2.6 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· 30th of 51
$58.88
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.