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 $2.63 Median $2.63 Typical High $2.63 | Facility | None | $2.63 | $2.63 | $2.63 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $2.63 Typical High $2.69 | Professional | None | $2.51 | $2.63 | $2.69 |
BCBS South Carolina Setting Facility Modifier None Typical Low $16.22 Median $18.20 Typical High $30.90 | Facility | None | $16.22 | $18.20 | $30.90 |
BCBS South Carolina Setting Professional Modifier None Typical Low $14.13 Median $117.49 Typical High $147.91 | Professional | None | $14.13 | $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 $2.63 Median $3.16 Typical High $26.30 | Facility | None | $2.63 | $3.16 | $26.30 |
Medcost Setting Professional Modifier None Typical Low $10.96 Median $12.30 Typical High $15.14 | Professional | None | $10.96 | $12.30 | $15.14 |
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 $1.26 Median $1.32 Typical High $1.35 | Professional | 52 · Reduced service | $1.26 | $1.32 | $1.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.52 Typical High $0.55 | Professional | 53 · Discontinued | $0.50 | $0.52 | $0.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.38 Median $0.39 Typical High $0.41 | Professional | 55 · Aftercare only | $0.38 | $0.39 | $0.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.26 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.25 | $0.26 | $0.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.17 Median $6.17 Typical High $8.51 | Professional | 51 · Multiple procedures | $6.17 | $6.17 | $8.51 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.51 Median $2.51 Typical High $3.39 | Professional | 80 · Assistant surgeon | $2.51 | $2.51 | $3.39 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.74 Median $1.74 Typical High $2.34 | Professional | 81 · Minimal assistant surgeon | $1.74 | $1.74 | $2.34 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.74 Median $1.74 Typical High $2.34 | Professional | 82 · Assistant surgeon, no resident | $1.74 | $1.74 | $2.34 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.74 Median $1.74 Typical High $2.34 | Professional | AS · PA/NP assist | $1.74 | $1.74 | $2.34 |
Where South Carolina sits
The same service costs 50.1 times more in Massachusetts than in Indiana. 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· 19th 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.