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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | None | $181.97 | $190.55 | $190.55 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $169.82 | Professional | None | $117.49 | $147.91 | $169.82 |
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 $190.55 Median $229.09 Typical High $512.86 | Facility | None | $190.55 | $229.09 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $426.58 Typical High $501.19 | Professional | None | $125.89 | $426.58 | $501.19 |
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 |
10 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 $91.20 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $91.20 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $36.31 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 54 · Surgery only | $138.04 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $27.54 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $18.20 | $19.05 | $19.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $79.43 Median $213.80 Typical High $213.80 | Professional | 51 · Multiple procedures | $79.43 | $213.80 | $213.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $85.11 Typical High $85.11 | Professional | 80 · Assistant surgeon | $31.62 | $85.11 | $85.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $21.88 Median $58.88 Typical High $58.88 | Professional | 81 · Minimal assistant surgeon | $21.88 | $58.88 | $58.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.88 Median $58.88 Typical High $58.88 | Professional | 82 · Assistant surgeon, no resident | $21.88 | $58.88 | $58.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $21.88 Median $58.88 Typical High $58.88 | Professional | AS · PA/NP assist | $21.88 | $58.88 | $58.88 |
Where South Carolina sits
The same service costs 3.6 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· 36th of 51
$148
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.