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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $53.70 | Professional | None | $45.71 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $22.91 Typical High $26.92 | Professional | 52 · Reduced service | $22.91 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $10.72 | Professional | 53 · Discontinued | $9.12 | $9.12 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $8.13 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $5.37 |
BCBS South Carolina Setting Professional Modifier None Typical Low $44.67 Median $79.43 Typical High $79.43 | Professional | None | $44.67 | $79.43 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Medcost Setting Facility Modifier None Typical Low $45.71 Median $57.54 Typical High $218.78 | Facility | None | $45.71 | $57.54 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $34.67 Median $36.31 Typical High $63.10 | Professional | None | $34.67 | $36.31 | $63.10 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $128.82 | Professional | None | $67.61 | $93.33 | $128.82 |
United Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $91.20 | Professional | None | $44.67 | $56.23 | $91.20 |
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 $17.38 Median $18.20 Typical High $38.90 | Professional | 51 · Multiple procedures | $17.38 | $18.20 | $38.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.92 Median $7.41 Typical High $15.85 | Professional | 80 · Assistant surgeon | $6.92 | $7.41 | $15.85 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.90 Median $5.13 Typical High $10.96 | Professional | 81 · Minimal assistant surgeon | $4.90 | $5.13 | $10.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.90 Median $5.13 Typical High $10.96 | Professional | 82 · Assistant surgeon, no resident | $4.90 | $5.13 | $10.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.90 Median $5.13 Typical High $10.96 | Professional | AS · PA/NP assist | $4.90 | $5.13 | $10.96 |
Where South Carolina sits
The same service costs 3.0 times more in North Dakota 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· 26th of 51
$54.95
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.