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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $102.33 Typical High $107.15 | Professional | None | $100.00 | $102.33 | $107.15 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $251.19 | Professional | None | $117.49 | $147.91 | $251.19 |
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 $102.33 Median $123.03 Typical High $281.84 | Facility | None | $102.33 | $123.03 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $281.84 | Professional | None | $151.36 | $204.17 | $281.84 |
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 $50.12 Median $51.29 Typical High $53.70 | Professional | 52 · Reduced service | $50.12 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $20.42 Typical High $21.38 | Professional | 53 · Discontinued | $19.95 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.49 Typical High $16.22 | Professional | 55 · Aftercare only | $14.79 | $15.49 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.00 | $10.23 | $10.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $102.33 Typical High $102.33 | Professional | 51 · Multiple procedures | $74.13 | $102.33 | $102.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.20 Median $40.74 Typical High $40.74 | Professional | 80 · Assistant surgeon | $30.20 | $40.74 | $40.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $20.89 Median $28.84 Typical High $28.84 | Professional | 81 · Minimal assistant surgeon | $20.89 | $28.84 | $28.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $20.89 Median $28.84 Typical High $28.84 | Professional | 82 · Assistant surgeon, no resident | $20.89 | $28.84 | $28.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $20.89 Median $28.84 Typical High $28.84 | Professional | AS · PA/NP assist | $20.89 | $28.84 | $28.84 |
Where South Carolina sits
The same service costs 2.5 times more in Wyoming than in New Jersey. 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· 25th 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.