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 $37.15 Median $37.15 Typical High $43.65 | Facility | None | $37.15 | $37.15 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $37.15 Typical High $43.65 | Professional | None | $34.67 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $18.62 Typical High $21.38 | Professional | 52 · Reduced service | $18.20 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.41 Typical High $8.71 | Professional | 53 · Discontinued | $7.24 | $7.41 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.62 Typical High $6.46 | Professional | 55 · Aftercare only | $5.37 | $5.62 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.72 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.63 | $3.72 | $4.37 |
Ambetter Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
BCBS South Carolina Setting Professional Modifier None Typical Low $16.98 Median $18.62 Typical High $30.20 | Professional | None | $16.98 | $18.62 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Medcost Setting Professional Modifier None Typical Low $18.20 Median $26.92 Typical High $30.90 | Professional | None | $18.20 | $26.92 | $30.90 |
Medcost Setting Facility Modifier None Typical Low $21.38 Median $37.15 Typical High $52.48 | Facility | None | $21.38 | $37.15 | $52.48 |
Medcost Setting Professional Modifier None Typical Low $16.98 Median $23.99 Typical High $36.31 | Professional | None | $16.98 | $23.99 | $36.31 |
United Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $23.99 | Facility | None | $21.88 | $21.88 | $23.99 |
United Setting Professional Modifier None Typical Low $20.42 Median $27.54 Typical High $39.81 | Professional | None | $20.42 | $27.54 | $39.81 |
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 $8.51 Median $12.02 Typical High $22.91 | Professional | 51 · Multiple procedures | $8.51 | $12.02 | $22.91 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.39 Median $4.79 Typical High $9.12 | Professional | 80 · Assistant surgeon | $3.39 | $4.79 | $9.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.40 Median $3.39 Typical High $6.46 | Professional | 81 · Minimal assistant surgeon | $2.40 | $3.39 | $6.46 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.40 Median $3.39 Typical High $6.46 | Professional | 82 · Assistant surgeon, no resident | $2.40 | $3.39 | $6.46 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.40 Median $3.39 Typical High $6.46 | Professional | AS · PA/NP assist | $2.40 | $3.39 | $6.46 |
Where South Carolina sits
The same service costs 3.8 times more in Alaska than in Indiana. 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· 47th of 51
$29.51
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.