How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $42.66 | Professional | None | $39.81 | $41.69 | $42.66 |
BCBS South Carolina Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
BCBS South Carolina Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $147.91 | Professional | None | $100.00 | $117.49 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $223.87 Typical High $309.03 | Facility | None | $144.54 | $223.87 | $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 $41.69 Median $48.98 Typical High $1,148.15 | Facility | None | $41.69 | $48.98 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $1,148.15 | Professional | None | $97.72 | $131.83 | $1,148.15 |
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 |
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 $19.95 Median $20.42 Typical High $21.38 | Professional | 52 · Reduced service | $19.95 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.32 Typical High $8.51 | Professional | 53 · Discontinued | $7.94 | $8.32 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.17 Typical High $6.46 | Professional | 55 · Aftercare only | $6.03 | $6.17 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.17 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.98 | $4.17 | $4.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $60.26 Median $66.07 Typical High $75.86 | Professional | 51 · Multiple procedures | $60.26 | $66.07 | $75.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $24.55 Median $26.30 Typical High $30.20 | Professional | 80 · Assistant surgeon | $24.55 | $26.30 | $30.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.98 Median $18.62 Typical High $20.89 | Professional | 81 · Minimal assistant surgeon | $16.98 | $18.62 | $20.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.98 Median $18.62 Typical High $20.89 | Professional | 82 · Assistant surgeon, no resident | $16.98 | $18.62 | $20.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.98 Median $18.62 Typical High $20.89 | Professional | AS · PA/NP assist | $16.98 | $18.62 | $20.89 |
Where South Carolina sits
The same service costs 25.1 times more in Wyoming than in Kentucky. 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· 32nd 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.