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 $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $48.98 | Professional | None | $46.77 | $46.77 | $48.98 |
BCBS South Carolina Setting Professional Modifier None Typical Low $36.31 Median $117.49 Typical High $147.91 | Professional | None | $36.31 | $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 $46.77 Median $56.23 Typical High $426.58 | Facility | None | $46.77 | $56.23 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $147.91 | Professional | None | $53.70 | $53.70 | $147.91 |
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 $23.44 Median $23.44 Typical High $24.55 | Professional | 52 · Reduced service | $23.44 | $23.44 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $9.77 | Professional | 53 · Discontinued | $9.33 | $9.33 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $7.24 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $4.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.92 Median $26.92 Typical High $154.88 | Professional | 51 · Multiple procedures | $26.92 | $26.92 | $154.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.96 Median $10.96 Typical High $61.66 | Professional | 80 · Assistant surgeon | $10.96 | $10.96 | $61.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.59 Median $7.59 Typical High $42.66 | Professional | 81 · Minimal assistant surgeon | $7.59 | $7.59 | $42.66 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.59 Median $7.59 Typical High $42.66 | Professional | 82 · Assistant surgeon, no resident | $7.59 | $7.59 | $42.66 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.59 Median $7.59 Typical High $42.66 | Professional | AS · PA/NP assist | $7.59 | $7.59 | $42.66 |
Where South Carolina sits
The same service costs 5.1 times more in North Dakota 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· 44th of 51
$117
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.