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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $70.79 Typical High $74.13 | Professional | None | $67.61 | $70.79 | $74.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $158.49 | Professional | None | $117.49 | $147.91 | $158.49 |
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 $70.79 Median $85.11 Typical High $234.42 | Facility | None | $70.79 | $85.11 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $208.93 | Professional | None | $42.66 | $42.66 | $208.93 |
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 $33.88 Median $35.48 Typical High $36.31 | Professional | 52 · Reduced service | $33.88 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.13 Typical High $14.79 | Professional | 53 · Discontinued | $13.49 | $14.13 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.72 Typical High $10.96 | Professional | 55 · Aftercare only | $10.23 | $10.72 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.08 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.76 | $7.08 | $7.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $21.38 Median $21.38 Typical High $77.62 | Professional | 51 · Multiple procedures | $21.38 | $21.38 | $77.62 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.51 Median $8.51 Typical High $31.62 | Professional | 80 · Assistant surgeon | $8.51 | $8.51 | $31.62 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.89 Median $5.89 Typical High $21.88 | Professional | 81 · Minimal assistant surgeon | $5.89 | $5.89 | $21.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.89 Median $5.89 Typical High $21.88 | Professional | 82 · Assistant surgeon, no resident | $5.89 | $5.89 | $21.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.89 Median $5.89 Typical High $21.88 | Professional | AS · PA/NP assist | $5.89 | $5.89 | $21.88 |
Where South Carolina sits
The same service costs 2.6 times more in Wyoming than in Washington, DC. 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· 27th 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.