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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $93.33 Typical High $93.33 | Professional | None | $91.20 | $93.33 | $93.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $186.21 | Professional | None | $117.49 | $147.91 | $186.21 |
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 $93.33 Median $112.20 Typical High $288.40 | Facility | None | $93.33 | $112.20 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $223.87 | Professional | None | $138.04 | $213.80 | $223.87 |
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 $44.67 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $44.67 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $18.20 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $13.49 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $9.12 | $9.33 | $9.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $107.15 Typical High $107.15 | Professional | 51 · Multiple procedures | $69.18 | $107.15 | $107.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $27.54 Median $42.66 Typical High $42.66 | Professional | 80 · Assistant surgeon | $27.54 | $42.66 | $42.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.50 Median $30.20 Typical High $30.20 | Professional | 81 · Minimal assistant surgeon | $19.50 | $30.20 | $30.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.50 Median $30.20 Typical High $30.20 | Professional | 82 · Assistant surgeon, no resident | $19.50 | $30.20 | $30.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.50 Median $30.20 Typical High $30.20 | Professional | AS · PA/NP assist | $19.50 | $30.20 | $30.20 |
Where South Carolina sits
The same service costs 2.1 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· 15th of 51
$126
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.