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 $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $39.81 | Professional | None | $38.90 | $38.90 | $39.81 |
BCBS South Carolina Setting Professional Modifier None Typical Low $46.77 Median $117.49 Typical High $147.91 | Professional | None | $46.77 | $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 $38.90 Median $46.77 Typical High $52.48 | Facility | None | $38.90 | $46.77 | $52.48 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $117.49 | Professional | None | $44.67 | $44.67 | $117.49 |
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 $19.50 Median $19.50 Typical High $19.95 | Professional | 52 · Reduced service | $19.50 | $19.50 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $7.94 | Professional | 53 · Discontinued | $7.76 | $7.76 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $6.03 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $3.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.39 Median $22.39 Typical High $123.03 | Professional | 51 · Multiple procedures | $22.39 | $22.39 | $123.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.91 Median $8.91 Typical High $48.98 | Professional | 80 · Assistant surgeon | $8.91 | $8.91 | $48.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.31 Median $6.31 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $6.31 | $6.31 | $33.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.31 Median $6.31 Typical High $33.88 | Professional | 82 · Assistant surgeon, no resident | $6.31 | $6.31 | $33.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.31 Median $6.31 Typical High $33.88 | Professional | AS · PA/NP assist | $6.31 | $6.31 | $33.88 |
Where South Carolina sits
The same service costs 4.8 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.