How much rates vary
Facilitymedian $224 · 10th to 90th $186 to $457Professionalmedian $309 · 10th to 90th $224 to $525
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 $199.53 Median $263.03 Typical High $354.81 | Facility | None | $199.53 | $263.03 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $354.81 | Professional | None | $199.53 | $263.03 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $478.63 | Professional | None | $389.05 | $478.63 | $478.63 |
BCBS South Carolina Setting Facility Modifier None Typical Low $144.54 Median $190.55 Typical High $457.09 | Facility | None | $144.54 | $190.55 | $457.09 |
BCBS South Carolina Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $478.63 | Professional | None | $338.84 | $354.81 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $446.68 | Professional | None | $398.11 | $398.11 | $446.68 |
Molina Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $912.01 | Professional | None | $446.68 | $588.84 | $912.01 |
United Setting Facility Modifier None Typical Low $741.31 Median $912.01 Typical High $1,174.90 | Facility | None | $741.31 | $912.01 | $1,174.90 |
United Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $524.81 | Professional | None | $263.03 | $363.08 | $524.81 |
10 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $177.83 Typical High $204.17 | Professional | 52 · Reduced service | $131.83 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $70.79 Typical High $81.28 | Professional | 53 · Discontinued | $53.70 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $53.70 Typical High $61.66 | Professional | 55 · Aftercare only | $39.81 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $35.48 Typical High $40.74 | Professional | 56 · Pre-op care only | $26.30 | $35.48 | $40.74 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $354.81 Median $478.63 Typical High $478.63 | Professional | 29 | $354.81 | $478.63 | $478.63 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $199.53 Median $199.53 Typical High $281.84 | Professional | 51 · Multiple procedures | $199.53 | $199.53 | $281.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $79.43 Typical High $112.20 | Professional | 80 · Assistant surgeon | $79.43 | $79.43 | $112.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $54.95 Median $54.95 Typical High $77.62 | Professional | 81 · Minimal assistant surgeon | $54.95 | $54.95 | $77.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $54.95 Median $54.95 Typical High $77.62 | Professional | 82 · Assistant surgeon, no resident | $54.95 | $54.95 | $77.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $54.95 Typical High $77.62 | Professional | AS · PA/NP assist | $54.95 | $54.95 | $77.62 |
Where South Carolina sits
The same service costs 2.1 times more in Wyoming than in Maryland. 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· 50th of 51
$309
WY $661MD $309
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.