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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $173.78 | Professional | None | $147.91 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $72.44 Typical High $85.11 | Professional | 52 · Reduced service | $72.44 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $34.67 | Professional | 53 · Discontinued | $29.51 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $25.70 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $17.38 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $17.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $147.91 Median $173.78 Typical High $478.63 | Facility | None | $147.91 | $173.78 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $123.03 Typical High $204.17 | Professional | None | $117.49 | $123.03 | $204.17 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $323.59 | Professional | None | $169.82 | $229.09 | $323.59 |
United Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $275.42 | Professional | None | $154.88 | $190.55 | $275.42 |
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 $58.88 Median $61.66 Typical High $125.89 | Professional | 51 · Multiple procedures | $58.88 | $61.66 | $125.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $23.44 Median $24.55 Typical High $50.12 | Professional | 80 · Assistant surgeon | $23.44 | $24.55 | $50.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.60 Median $17.38 Typical High $35.48 | Professional | 81 · Minimal assistant surgeon | $16.60 | $17.38 | $35.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.60 Median $17.38 Typical High $35.48 | Professional | 82 · Assistant surgeon, no resident | $16.60 | $17.38 | $35.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.60 Median $17.38 Typical High $35.48 | Professional | AS · PA/NP assist | $16.60 | $17.38 | $35.48 |
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· 22nd of 51
$178
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.