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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $83.18 Typical High $87.10 | Professional | None | $81.28 | $83.18 | $87.10 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $588.84 | Professional | None | $117.49 | $147.91 | $588.84 |
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 $83.18 Median $100.00 Typical High $1,778.28 | Facility | None | $83.18 | $100.00 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $776.25 | Professional | None | $97.72 | $97.72 | $776.25 |
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 $40.74 Median $41.69 Typical High $43.65 | Professional | 52 · Reduced service | $40.74 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.98 Typical High $17.38 | Professional | 53 · Discontinued | $16.22 | $16.98 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.59 Typical High $13.18 | Professional | 55 · Aftercare only | $12.02 | $12.59 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.32 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.13 | $8.32 | $8.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $48.98 Typical High $588.84 | Professional | 51 · Multiple procedures | $48.98 | $48.98 | $588.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.50 Median $19.50 Typical High $239.88 | Professional | 80 · Assistant surgeon | $19.50 | $19.50 | $239.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.80 Median $13.80 Typical High $165.96 | Professional | 81 · Minimal assistant surgeon | $13.80 | $13.80 | $165.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.80 Median $13.80 Typical High $165.96 | Professional | 82 · Assistant surgeon, no resident | $13.80 | $13.80 | $165.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.80 Median $13.80 Typical High $165.96 | Professional | AS · PA/NP assist | $13.80 | $13.80 | $165.96 |
Where South Carolina sits
The same service costs 7.2 times more in Hawaii 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· 17th 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.