How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $158.49 Median $158.49 Typical High $1,174.90 | Facility | None | $158.49 | $158.49 | $1,174.90 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | None | $151.36 | $158.49 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $190.55 Median $457.09 Typical High $676.08 | Facility | None | $190.55 | $457.09 | $676.08 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $251.19 | Professional | None | $117.49 | $147.91 | $251.19 |
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 $158.49 Median $190.55 Typical High $457.09 | Facility | None | $158.49 | $190.55 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $398.11 | Professional | None | $158.49 | $158.49 | $398.11 |
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 $75.86 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $75.86 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $30.20 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $22.91 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.14 | $15.85 | $15.85 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $79.43 Median $79.43 Typical High $141.25 | Professional | 51 · Multiple procedures | $79.43 | $79.43 | $141.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $31.62 Typical High $57.54 | Professional | 80 · Assistant surgeon | $31.62 | $31.62 | $57.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $22.39 Median $22.39 Typical High $39.81 | Professional | 81 · Minimal assistant surgeon | $22.39 | $22.39 | $39.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $22.39 Median $22.39 Typical High $39.81 | Professional | 82 · Assistant surgeon, no resident | $22.39 | $22.39 | $39.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $22.39 Median $22.39 Typical High $39.81 | Professional | AS · PA/NP assist | $22.39 | $22.39 | $39.81 |
Where South Carolina sits
The same service costs 2.9 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.