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 $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | None | $489.78 | $512.86 | $512.86 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $933.25 | Professional | None | $117.49 | $147.91 | $933.25 |
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 $512.86 Median $616.60 Typical High $2,089.30 | Facility | None | $512.86 | $616.60 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $977.24 | Professional | None | $870.96 | $933.25 | $977.24 |
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 $245.47 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $245.47 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $97.72 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $51.29 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $467.74 Typical High $602.56 | Professional | 51 · Multiple procedures | $380.19 | $467.74 | $602.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $186.21 Typical High $239.88 | Professional | 80 · Assistant surgeon | $154.88 | $186.21 | $239.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $131.83 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $107.15 | $131.83 | $169.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $131.83 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $131.83 | $169.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $131.83 Typical High $169.82 | Professional | AS · PA/NP assist | $107.15 | $131.83 | $169.82 |
Where South Carolina sits
The same service costs 7.1 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.