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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $123.03 | Professional | None | $104.71 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $51.29 Typical High $61.66 | Professional | 52 · Reduced service | $51.29 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $24.55 | Professional | 53 · Discontinued | $20.89 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $18.62 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $12.30 |
BCBS South Carolina Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Medcost Setting Facility Modifier None Typical Low $104.71 Median $123.03 Typical High $338.84 | Facility | None | $104.71 | $123.03 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $89.13 Typical High $141.25 | Professional | None | $83.18 | $89.13 | $141.25 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $194.98 | Professional | None | $102.33 | $138.04 | $194.98 |
United Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $194.98 | Professional | None | $112.20 | $138.04 | $194.98 |
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 $41.69 Median $44.67 Typical High $89.13 | Professional | 51 · Multiple procedures | $41.69 | $44.67 | $89.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.60 Median $17.78 Typical High $35.48 | Professional | 80 · Assistant surgeon | $16.60 | $17.78 | $35.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.75 Median $12.30 Typical High $25.12 | Professional | 81 · Minimal assistant surgeon | $11.75 | $12.30 | $25.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.75 Median $12.30 Typical High $25.12 | Professional | 82 · Assistant surgeon, no resident | $11.75 | $12.30 | $25.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $11.75 Median $12.30 Typical High $25.12 | Professional | AS · PA/NP assist | $11.75 | $12.30 | $25.12 |
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· 26th of 51
$123
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.