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 $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,659.59 | $1,737.80 | $1,737.80 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $1,230.27 | Professional | None | $117.49 | $147.91 | $1,230.27 |
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 $1,548.82 Median $1,737.80 Typical High $4,677.35 | Facility | None | $1,548.82 | $1,737.80 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,995.26 | Professional | None | $933.25 | $933.25 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
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 $812.83 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $812.83 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $331.13 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,230.27 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $245.47 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $165.96 | $173.78 | $173.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $467.74 Median $467.74 Typical High $1,380.38 | Professional | 51 · Multiple procedures | $467.74 | $467.74 | $1,380.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $186.21 Typical High $549.54 | Professional | 80 · Assistant surgeon | $186.21 | $186.21 | $549.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $131.83 Median $131.83 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $131.83 | $131.83 | $389.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $131.83 Median $131.83 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $131.83 | $131.83 | $389.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $131.83 Typical High $389.05 | Professional | AS · PA/NP assist | $131.83 | $131.83 | $389.05 |
Where South Carolina sits
The same service costs 15.1 times more in Arkansas 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.