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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $31.62 Typical High $31.62 | Professional | None | $30.20 | $31.62 | $31.62 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $147.91 | Professional | None | $117.49 | $147.91 | $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 $31.62 Median $38.02 Typical High $131.83 | Facility | None | $31.62 | $38.02 | $131.83 |
Medcost Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $42.66 | Professional | None | $30.90 | $30.90 | $42.66 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $245.47 | Professional | None | $120.23 | $169.82 | $245.47 |
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 $15.14 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $15.14 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $6.03 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.57 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $3.02 | $3.16 | $3.16 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.49 Median $15.49 Typical High $28.84 | Professional | 51 · Multiple procedures | $15.49 | $15.49 | $28.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.17 Median $6.17 Typical High $11.75 | Professional | 80 · Assistant surgeon | $6.17 | $6.17 | $11.75 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.27 Median $4.27 Typical High $8.13 | Professional | 81 · Minimal assistant surgeon | $4.27 | $4.27 | $8.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.27 Median $4.27 Typical High $8.13 | Professional | 82 · Assistant surgeon, no resident | $4.27 | $4.27 | $8.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.27 Median $4.27 Typical High $8.13 | Professional | AS · PA/NP assist | $4.27 | $4.27 | $8.13 |
Where South Carolina sits
The same service costs 4.2 times more in Wyoming than in Pennsylvania. 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· 9th of 51
$126
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.