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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $44.67 | Professional | None | $42.66 | $43.65 | $44.67 |
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 $43.65 Median $52.48 Typical High $58.88 | Facility | None | $43.65 | $52.48 | $58.88 |
Medcost Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $117.49 | Professional | None | $12.30 | $12.30 | $117.49 |
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 $21.38 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.38 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.71 Typical High $8.91 | Professional | 53 · Discontinued | $8.51 | $8.71 | $8.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $33.11 Typical High $33.11 | Professional | 54 · Surgery only | $31.62 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.46 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.37 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.27 | $4.37 | $4.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.17 Median $6.17 Typical High $123.03 | Professional | 51 · Multiple procedures | $6.17 | $6.17 | $123.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.45 Median $2.45 Typical High $48.98 | Professional | 80 · Assistant surgeon | $2.45 | $2.45 | $48.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.74 Median $1.74 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $1.74 | $1.74 | $33.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.74 Median $1.74 Typical High $33.88 | Professional | 82 · Assistant surgeon, no resident | $1.74 | $1.74 | $33.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.74 Median $1.74 Typical High $33.88 | Professional | AS · PA/NP assist | $1.74 | $1.74 | $33.88 |
Where South Carolina sits
The same service costs 6.3 times more in North Dakota than in Hawaii. 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· 31st 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.