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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | None | $87.10 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $43.65 Typical High $52.48 | Professional | 52 · Reduced service | $43.65 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $20.89 | Professional | 53 · Discontinued | $17.38 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $15.49 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $10.47 |
BCBS South Carolina Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $104.71 Typical High $288.40 | Facility | None | $87.10 | $104.71 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $72.44 Typical High $120.23 | Professional | None | $70.79 | $72.44 | $120.23 |
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 $93.33 Median $114.82 Typical High $162.18 | Professional | None | $93.33 | $114.82 | $162.18 |
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 $35.48 Median $36.31 Typical High $75.86 | Professional | 51 · Multiple procedures | $35.48 | $36.31 | $75.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.13 Median $14.79 Typical High $30.20 | Professional | 80 · Assistant surgeon | $14.13 | $14.79 | $30.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.77 Median $10.23 Typical High $20.89 | Professional | 81 · Minimal assistant surgeon | $9.77 | $10.23 | $20.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.77 Median $10.23 Typical High $20.89 | Professional | 82 · Assistant surgeon, no resident | $9.77 | $10.23 | $20.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.77 Median $10.23 Typical High $20.89 | Professional | AS · PA/NP assist | $9.77 | $10.23 | $20.89 |
Where South Carolina sits
The same service costs 2.5 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· 29th of 51
$100
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.