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 $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $691.83 | Professional | None | $660.69 | $691.83 | $691.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $1,737.80 | Professional | None | $117.49 | $147.91 | $1,737.80 |
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 $691.83 Median $831.76 Typical High $3,630.78 | Facility | None | $691.83 | $831.76 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $2,290.87 | Professional | None | $457.09 | $457.09 | $2,290.87 |
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 $331.13 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $331.13 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $131.83 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $97.72 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $66.07 | $69.18 | $69.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $229.09 Median $229.09 Typical High $1,584.89 | Professional | 51 · Multiple procedures | $229.09 | $229.09 | $1,584.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $91.20 Typical High $645.65 | Professional | 80 · Assistant surgeon | $91.20 | $91.20 | $645.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $64.57 Median $64.57 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $64.57 | $64.57 | $446.68 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $64.57 Median $64.57 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $64.57 | $64.57 | $446.68 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $64.57 Typical High $446.68 | Professional | AS · PA/NP assist | $64.57 | $64.57 | $446.68 |
Where South Carolina sits
The same service costs 12.6 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.