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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | None | $102.33 | $107.15 | $107.15 |
BCBS South Carolina Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
BCBS South Carolina Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $147.91 | Professional | None | $97.72 | $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 $107.15 Median $128.82 Typical High $309.03 | Facility | None | $107.15 | $128.82 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $269.15 | Professional | None | $120.23 | $181.97 | $269.15 |
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 $51.29 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $51.29 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $20.42 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.14 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.23 | $10.72 | $10.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $91.20 Typical High $93.33 | Professional | 51 · Multiple procedures | $74.13 | $91.20 | $93.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $29.51 Median $36.31 Typical High $37.15 | Professional | 80 · Assistant surgeon | $29.51 | $36.31 | $37.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $20.42 Median $25.12 Typical High $26.30 | Professional | 81 · Minimal assistant surgeon | $20.42 | $25.12 | $26.30 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $20.42 Median $25.12 Typical High $26.30 | Professional | 82 · Assistant surgeon, no resident | $20.42 | $25.12 | $26.30 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $20.42 Median $25.12 Typical High $26.30 | Professional | AS · PA/NP assist | $20.42 | $25.12 | $26.30 |
Where South Carolina sits
The same service costs 2.4 times more in Wyoming 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· 39th of 51
$120
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.