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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $134.90 | Professional | None | $125.89 | $128.82 | $134.90 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $229.09 | Professional | None | $117.49 | $147.91 | $229.09 |
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 $128.82 Median $154.88 Typical High $371.54 | Facility | None | $128.82 | $154.88 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $269.15 | Professional | None | $190.55 | $251.19 | $269.15 |
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 $63.10 Median $64.57 Typical High $67.61 | Professional | 52 · Reduced service | $63.10 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.70 Typical High $26.92 | Professional | 53 · Discontinued | $25.12 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.50 Typical High $20.42 | Professional | 55 · Aftercare only | $18.62 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.88 Typical High $13.49 | Professional | 56 · Pre-op care only | $12.59 | $12.88 | $13.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $85.11 Median $125.89 Typical High $131.83 | Professional | 51 · Multiple procedures | $85.11 | $125.89 | $131.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.88 Median $50.12 Typical High $52.48 | Professional | 80 · Assistant surgeon | $33.88 | $50.12 | $52.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $23.99 Median $34.67 Typical High $37.15 | Professional | 81 · Minimal assistant surgeon | $23.99 | $34.67 | $37.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $23.99 Median $34.67 Typical High $37.15 | Professional | 82 · Assistant surgeon, no resident | $23.99 | $34.67 | $37.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $23.99 Median $34.67 Typical High $37.15 | Professional | AS · PA/NP assist | $23.99 | $34.67 | $37.15 |
Where South Carolina sits
The same service costs 1.9 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· 13th of 51
$129
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.