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 $40.74 Median $40.74 Typical High $64.57 | Facility | None | $40.74 | $40.74 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $52.48 Typical High $64.57 | Professional | None | $40.74 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $24.55 Typical High $32.36 | Professional | 52 · Reduced service | $20.42 | $24.55 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $7.41 Typical High $9.55 | Professional | 55 · Aftercare only | $6.17 | $7.41 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.90 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.07 | $4.90 | $6.46 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
BCBS South Carolina Setting Facility Modifier None Typical Low $131.83 Median $223.87 Typical High $380.19 | Facility | None | $131.83 | $223.87 | $380.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $33.88 Median $63.10 Typical High $63.10 | Professional | None | $33.88 | $63.10 | $63.10 |
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 Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $97.72 | Professional | None | $72.44 | $91.20 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $40.74 Median $60.26 Typical High $77.62 | Facility | None | $40.74 | $60.26 | $77.62 |
Medcost Setting Professional Modifier None Typical Low $60.26 Median $64.57 Typical High $83.18 | Professional | None | $60.26 | $64.57 | $83.18 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $123.03 | Professional | None | $60.26 | $77.62 | $123.03 |
United Setting Facility Modifier None Typical Low $562.34 Median $676.08 Typical High $891.25 | Facility | None | $562.34 | $676.08 | $891.25 |
United Setting Professional Modifier None Typical Low $38.02 Median $53.70 Typical High $74.13 | Professional | None | $38.02 | $53.70 | $74.13 |
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 $30.20 Median $32.36 Typical High $45.71 | Professional | 51 · Multiple procedures | $30.20 | $32.36 | $45.71 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.02 Median $12.88 Typical High $18.20 | Professional | 80 · Assistant surgeon | $12.02 | $12.88 | $18.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.51 Median $8.91 Typical High $12.88 | Professional | 81 · Minimal assistant surgeon | $8.51 | $8.91 | $12.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.51 Median $8.91 Typical High $12.88 | Professional | 82 · Assistant surgeon, no resident | $8.51 | $8.91 | $12.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.51 Median $8.91 Typical High $12.88 | Professional | AS · PA/NP assist | $8.51 | $8.91 | $12.88 |
Where South Carolina sits
The same service costs 2.3 times more in Alaska than in Kentucky. 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· 19th of 51
$61.66
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.