How much rates vary
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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $75.86 | Professional | None | $70.79 | $75.86 | $75.86 |
BCBS South Carolina Setting Facility Modifier None Typical Low $75.86 Median $173.78 Typical High $251.19 | Facility | None | $75.86 | $173.78 | $251.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $147.91 | Professional | None | $95.50 | $117.49 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $177.83 Typical High $309.03 | Facility | None | $144.54 | $177.83 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medcost Setting Facility Modifier None Typical Low $18.62 Median $83.18 Typical High $104.71 | Facility | None | $18.62 | $83.18 | $104.71 |
Medcost Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $104.71 | Professional | None | $14.13 | $14.13 | $104.71 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | None | $107.15 | $125.89 | $125.89 |
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 $35.48 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $35.48 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $14.45 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $10.72 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.08 | $7.59 | $7.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $7.08 Median $7.08 Typical High $24.55 | Professional | 51 · Multiple procedures | $7.08 | $7.08 | $24.55 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.82 Median $2.82 Typical High $9.77 | Professional | 80 · Assistant surgeon | $2.82 | $2.82 | $9.77 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.95 Median $1.95 Typical High $6.76 | Professional | 81 · Minimal assistant surgeon | $1.95 | $1.95 | $6.76 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.95 Median $1.95 Typical High $6.76 | Professional | 82 · Assistant surgeon, no resident | $1.95 | $1.95 | $6.76 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.95 Median $1.95 Typical High $6.76 | Professional | AS · PA/NP assist | $1.95 | $1.95 | $6.76 |
Where South Carolina sits
The same service costs 2.0 times more in North Dakota 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· 21st of 51
$117
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.