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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $112.20 Typical High $117.49 | Professional | None | $107.15 | $112.20 | $117.49 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $269.15 | Professional | None | $117.49 | $147.91 | $269.15 |
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 $112.20 Median $134.90 Typical High $562.34 | Facility | None | $112.20 | $134.90 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $562.34 | Professional | None | $165.96 | $165.96 | $562.34 |
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 $53.70 Median $56.23 Typical High $57.54 | Professional | 52 · Reduced service | $53.70 | $56.23 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $22.39 Typical High $23.44 | Professional | 53 · Discontinued | $21.38 | $22.39 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.98 Typical High $17.38 | Professional | 55 · Aftercare only | $16.22 | $16.98 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.22 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.72 | $11.22 | $11.75 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $83.18 Typical High $281.84 | Professional | 51 · Multiple procedures | $83.18 | $83.18 | $281.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.88 Median $33.88 Typical High $112.20 | Professional | 80 · Assistant surgeon | $33.88 | $33.88 | $112.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $23.44 Median $23.44 Typical High $77.62 | Professional | 81 · Minimal assistant surgeon | $23.44 | $23.44 | $77.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $23.44 Median $23.44 Typical High $77.62 | Professional | 82 · Assistant surgeon, no resident | $23.44 | $23.44 | $77.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $23.44 Median $23.44 Typical High $77.62 | Professional | AS · PA/NP assist | $23.44 | $23.44 | $77.62 |
Where South Carolina sits
The same service costs 6.0 times more in Wyoming than in Montana. 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· 23rd 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.