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 $20.89 Median $20.89 Typical High $22.91 | Facility | None | $20.89 | $20.89 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $20.89 Typical High $22.91 | Professional | None | $19.95 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.00 Median $10.47 Typical High $11.48 | Professional | 52 · Reduced service | $10.00 | $10.47 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $4.17 Typical High $4.57 | Professional | 53 · Discontinued | $3.98 | $4.17 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.16 Typical High $3.39 | Professional | 55 · Aftercare only | $3.02 | $3.16 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.09 Typical High $2.29 | Professional | 56 · Pre-op care only | $2.00 | $2.09 | $2.29 |
BCBS South Carolina Setting Facility Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $10,964.78 | Facility | None | $10,964.78 | $10,964.78 | $10,964.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $12.02 Median $16.22 Typical High $16.22 | Professional | None | $12.02 | $16.22 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Medcost Setting Professional Modifier None Typical Low $7.41 Median $11.22 Typical High $15.49 | Professional | None | $7.41 | $11.22 | $15.49 |
Medcost Setting Facility Modifier None Typical Low $12.02 Median $20.89 Typical High $28.18 | Facility | None | $12.02 | $20.89 | $28.18 |
Medcost Setting Professional Modifier None Typical Low $7.08 Median $12.30 Typical High $19.50 | Professional | None | $7.08 | $12.30 | $19.50 |
United Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $13.49 | Facility | None | $12.30 | $12.30 | $13.49 |
United Setting Professional Modifier None Typical Low $11.48 Median $15.14 Typical High $21.38 | Professional | None | $11.48 | $15.14 | $21.38 |
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 $3.47 Median $6.17 Typical High $12.02 | Professional | 51 · Multiple procedures | $3.47 | $6.17 | $12.02 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1.41 Median $2.45 Typical High $4.79 | Professional | 80 · Assistant surgeon | $1.41 | $2.45 | $4.79 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.98 Median $1.70 Typical High $3.39 | Professional | 81 · Minimal assistant surgeon | $0.98 | $1.70 | $3.39 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.98 Median $1.70 Typical High $3.39 | Professional | 82 · Assistant surgeon, no resident | $0.98 | $1.70 | $3.39 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $0.98 Median $1.70 Typical High $3.39 | Professional | AS · PA/NP assist | $0.98 | $1.70 | $3.39 |
Where South Carolina sits
The same service costs 3.2 times more in Alaska than in New York. 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
$16.22
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.