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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $52.48 | Professional | None | $40.74 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $20.42 Typical High $26.30 | Professional | 52 · Reduced service | $20.42 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $10.72 | Professional | 53 · Discontinued | $8.13 | $8.13 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $7.94 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $5.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Medcost Setting Facility Modifier None Typical Low $40.74 Median $48.98 Typical High $134.90 | Facility | None | $40.74 | $48.98 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $60.26 | Professional | None | $32.36 | $38.02 | $60.26 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $54.95 Typical High $66.07 | Professional | None | $35.48 | $54.95 | $66.07 |
United Setting Professional Modifier None Typical Low $46.77 Median $57.54 Typical High $81.28 | Professional | None | $46.77 | $57.54 | $81.28 |
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 $16.22 Median $19.05 Typical High $34.67 | Professional | 51 · Multiple procedures | $16.22 | $19.05 | $34.67 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.46 Median $7.59 Typical High $14.13 | Professional | 80 · Assistant surgeon | $6.46 | $7.59 | $14.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.57 Median $5.37 Typical High $9.77 | Professional | 81 · Minimal assistant surgeon | $4.57 | $5.37 | $9.77 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.57 Median $5.37 Typical High $9.77 | Professional | 82 · Assistant surgeon, no resident | $4.57 | $5.37 | $9.77 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.57 Median $5.37 Typical High $9.77 | Professional | AS · PA/NP assist | $4.57 | $5.37 | $9.77 |
Where South Carolina sits
The same service costs 2.6 times more in Alaska than in Arizona. 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
$47.86
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.