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 $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $363.08 Typical High $380.19 | Professional | None | $354.81 | $363.08 | $380.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $151.36 | Professional | None | $117.49 | $147.91 | $151.36 |
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 $363.08 Median $436.52 Typical High $1,000.00 | Facility | None | $363.08 | $436.52 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $812.83 | Professional | None | $281.84 | $281.84 | $812.83 |
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 $177.83 Median $181.97 Typical High $190.55 | Professional | 52 · Reduced service | $177.83 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $74.13 Typical High $75.86 | Professional | 53 · Discontinued | $70.79 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $54.95 Typical High $57.54 | Professional | 55 · Aftercare only | $52.48 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $36.31 Typical High $38.02 | Professional | 56 · Pre-op care only | $35.48 | $36.31 | $38.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $141.25 Median $141.25 Typical High $398.11 | Professional | 51 · Multiple procedures | $141.25 | $141.25 | $398.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $57.54 Typical High $158.49 | Professional | 80 · Assistant surgeon | $57.54 | $57.54 | $158.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $39.81 Median $39.81 Typical High $112.20 | Professional | 81 · Minimal assistant surgeon | $39.81 | $39.81 | $112.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $39.81 Median $39.81 Typical High $112.20 | Professional | 82 · Assistant surgeon, no resident | $39.81 | $39.81 | $112.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $39.81 Median $39.81 Typical High $112.20 | Professional | AS · PA/NP assist | $39.81 | $39.81 | $112.20 |
Where South Carolina sits
The same service costs 5.9 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· 35th 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.