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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | None | $107.15 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | 52 · Reduced service | $53.70 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | 53 · Discontinued | $21.38 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $19.05 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $12.59 |
BCBS South Carolina Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $165.96 | Professional | None | $107.15 | $162.18 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Medcost Setting Facility Modifier None Typical Low $107.15 Median $134.90 Typical High $446.68 | Facility | None | $107.15 | $134.90 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $87.10 Typical High $147.91 | Professional | None | $85.11 | $87.10 | $147.91 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $257.04 | Professional | None | $134.90 | $194.98 | $257.04 |
United Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $218.78 | Professional | None | $112.20 | $138.04 | $218.78 |
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 $42.66 Median $43.65 Typical High $91.20 | Professional | 51 · Multiple procedures | $42.66 | $43.65 | $91.20 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.98 Median $17.38 Typical High $36.31 | Professional | 80 · Assistant surgeon | $16.98 | $17.38 | $36.31 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.02 Median $12.30 Typical High $25.70 | Professional | 81 · Minimal assistant surgeon | $12.02 | $12.30 | $25.70 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.02 Median $12.30 Typical High $25.70 | Professional | 82 · Assistant surgeon, no resident | $12.02 | $12.30 | $25.70 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.02 Median $12.30 Typical High $25.70 | Professional | AS · PA/NP assist | $12.02 | $12.30 | $25.70 |
Where South Carolina sits
The same service costs 2.6 times more in North Dakota than in Delaware. 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· 25th of 51
$129
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.