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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $72.44 Typical High $72.44 | Professional | None | $69.18 | $72.44 | $72.44 |
BCBS South Carolina Setting Professional Modifier None Typical Low $18.20 Median $117.49 Typical High $147.91 | Professional | None | $18.20 | $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 $60.26 Median $72.44 Typical High $229.09 | Facility | None | $60.26 | $72.44 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $107.15 | Professional | None | $35.48 | $35.48 | $107.15 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $87.10 | Professional | None | $83.18 | $83.18 | $87.10 |
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 $34.67 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $34.67 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $13.80 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $10.47 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.92 | $7.24 | $7.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $17.78 Median $17.78 Typical High $74.13 | Professional | 51 · Multiple procedures | $17.78 | $17.78 | $74.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.08 Median $7.08 Typical High $29.51 | Professional | 80 · Assistant surgeon | $7.08 | $7.08 | $29.51 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.01 Median $5.01 Typical High $20.42 | Professional | 81 · Minimal assistant surgeon | $5.01 | $5.01 | $20.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.01 Median $5.01 Typical High $20.42 | Professional | 82 · Assistant surgeon, no resident | $5.01 | $5.01 | $20.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.01 Median $5.01 Typical High $20.42 | Professional | AS · PA/NP assist | $5.01 | $5.01 | $20.42 |
Where South Carolina sits
The same service costs 2.7 times more in North Dakota than in North Carolina. 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.