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 $9.12 Median $9.12 Typical High $9.12 | Facility | None | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $9.12 Typical High $9.12 | Professional | None | $8.13 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.35 Typical High $1.35 | Professional | 55 · Aftercare only | $1.23 | $1.35 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.89 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.81 | $0.89 | $0.89 |
Ambetter Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $8.71 Median $10.00 Typical High $10.00 | Professional | None | $8.71 | $10.00 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
Medcost Setting Professional Modifier None Typical Low $11.22 Median $13.80 Typical High $14.13 | Professional | None | $11.22 | $13.80 | $14.13 |
Medcost Setting Facility Modifier None Typical Low $8.71 Median $9.33 Typical High $12.30 | Facility | None | $8.71 | $9.33 | $12.30 |
Medcost Setting Professional Modifier None Typical Low $9.12 Median $10.00 Typical High $11.75 | Professional | None | $9.12 | $10.00 | $11.75 |
United Setting Professional Modifier None Typical Low $7.59 Median $8.91 Typical High $12.88 | Professional | None | $7.59 | $8.91 | $12.88 |
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 $4.57 Median $5.01 Typical High $6.31 | Professional | 51 · Multiple procedures | $4.57 | $5.01 | $6.31 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1.82 Median $2.00 Typical High $2.57 | Professional | 80 · Assistant surgeon | $1.82 | $2.00 | $2.57 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.29 Median $1.41 Typical High $1.78 | Professional | 81 · Minimal assistant surgeon | $1.29 | $1.41 | $1.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.29 Median $1.41 Typical High $1.78 | Professional | 82 · Assistant surgeon, no resident | $1.29 | $1.41 | $1.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.29 Median $1.41 Typical High $1.78 | Professional | AS · PA/NP assist | $1.29 | $1.41 | $1.78 |
Where South Carolina sits
The same service costs 2.6 times more in Alaska than in Florida. 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· 32nd of 51
$9.12
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.