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 $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $33.88 | Professional | None | $29.51 | $29.51 | $33.88 |
BCBS South Carolina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Medcost Setting Facility Modifier None Typical Low $29.51 Median $34.67 Typical High $42.66 | Facility | None | $29.51 | $34.67 | $42.66 |
Medcost Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $39.81 | Professional | None | $35.48 | $35.48 | $39.81 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $41.69 Typical High $64.57 | Professional | None | $32.36 | $41.69 | $64.57 |
United Setting Professional Modifier None Typical Low $29.51 Median $35.48 Typical High $47.86 | Professional | None | $29.51 | $35.48 | $47.86 |
9 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 $14.45 Median $14.45 Typical High $16.98 | Professional | 52 · Reduced service | $14.45 | $14.45 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $6.76 | Professional | 53 · Discontinued | $5.89 | $5.89 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $5.01 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $3.39 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $17.78 Median $17.78 Typical High $25.12 | Professional | 51 · Multiple procedures | $17.78 | $17.78 | $25.12 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.08 Median $7.08 Typical High $10.00 | Professional | 80 · Assistant surgeon | $7.08 | $7.08 | $10.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.90 Median $4.90 Typical High $7.08 | Professional | 81 · Minimal assistant surgeon | $4.90 | $4.90 | $7.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.90 Median $4.90 Typical High $7.08 | Professional | 82 · Assistant surgeon, no resident | $4.90 | $4.90 | $7.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.90 Median $4.90 Typical High $7.08 | Professional | AS · PA/NP assist | $4.90 | $4.90 | $7.08 |
Where South Carolina sits
The same service costs 3.0 times more in Alaska than in New York. 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· 30th of 51
$33.11
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.