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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | None | $138.04 | $144.54 | $144.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $181.97 | Professional | None | $117.49 | $147.91 | $181.97 |
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 $144.54 Median $173.78 Typical High $398.11 | Facility | None | $144.54 | $173.78 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $165.96 Typical High $281.84 | Professional | None | $162.18 | $165.96 | $281.84 |
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 $69.18 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $69.18 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $27.54 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $20.89 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $13.80 | $14.45 | $14.45 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $83.18 Typical High $125.89 | Professional | 51 · Multiple procedures | $83.18 | $83.18 | $125.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.88 Median $33.88 Typical High $50.12 | Professional | 80 · Assistant surgeon | $33.88 | $33.88 | $50.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $23.44 Median $23.44 Typical High $34.67 | Professional | 81 · Minimal assistant surgeon | $23.44 | $23.44 | $34.67 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $23.44 Median $23.44 Typical High $34.67 | Professional | 82 · Assistant surgeon, no resident | $23.44 | $23.44 | $34.67 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $23.44 Median $23.44 Typical High $34.67 | Professional | AS · PA/NP assist | $23.44 | $23.44 | $34.67 |
Where South Carolina sits
The same service costs 2.2 times more in Alaska 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· 14th of 51
$145
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.