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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $114.82 | Professional | None | $100.00 | $100.00 | $114.82 |
BCBS South Carolina Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Medcost Setting Facility Modifier None Typical Low $100.00 Median $120.23 Typical High $144.54 | Facility | None | $100.00 | $120.23 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $138.04 | Professional | None | $120.23 | $120.23 | $138.04 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $194.98 | Professional | None | $97.72 | $125.89 | $194.98 |
United Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $162.18 | Professional | None | $100.00 | $120.23 | $162.18 |
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 $50.12 Median $50.12 Typical High $57.54 | Professional | 52 · Reduced service | $50.12 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $22.91 | Professional | 53 · Discontinued | $19.95 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $17.38 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $11.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $60.26 Median $60.26 Typical High $87.10 | Professional | 51 · Multiple procedures | $60.26 | $60.26 | $87.10 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $23.99 Median $23.99 Typical High $34.67 | Professional | 80 · Assistant surgeon | $23.99 | $23.99 | $34.67 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.98 Median $16.98 Typical High $23.99 | Professional | 81 · Minimal assistant surgeon | $16.98 | $16.98 | $23.99 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.98 Median $16.98 Typical High $23.99 | Professional | 82 · Assistant surgeon, no resident | $16.98 | $16.98 | $23.99 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.98 Median $16.98 Typical High $23.99 | Professional | AS · PA/NP assist | $16.98 | $16.98 | $23.99 |
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
$115
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.