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 $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $79.43 Typical High $83.18 | Professional | None | $77.62 | $79.43 | $83.18 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $263.03 | Professional | None | $117.49 | $147.91 | $263.03 |
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 $79.43 Median $95.50 Typical High $338.84 | Facility | None | $79.43 | $95.50 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $338.84 | Professional | None | $169.82 | $169.82 | $338.84 |
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 $38.02 Median $39.81 Typical High $41.69 | Professional | 52 · Reduced service | $38.02 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.85 Typical High $16.60 | Professional | 53 · Discontinued | $15.49 | $15.85 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.02 Typical High $12.30 | Professional | 55 · Aftercare only | $11.48 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.94 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.76 | $7.94 | $8.32 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $85.11 Median $85.11 Typical High $158.49 | Professional | 51 · Multiple procedures | $85.11 | $85.11 | $158.49 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.88 Median $33.88 Typical High $63.10 | Professional | 80 · Assistant surgeon | $33.88 | $33.88 | $63.10 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $23.99 Median $23.99 Typical High $44.67 | Professional | 81 · Minimal assistant surgeon | $23.99 | $23.99 | $44.67 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $23.99 Median $23.99 Typical High $44.67 | Professional | 82 · Assistant surgeon, no resident | $23.99 | $23.99 | $44.67 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $23.99 Median $23.99 Typical High $44.67 | Professional | AS · PA/NP assist | $23.99 | $23.99 | $44.67 |
Where South Carolina sits
The same service costs 3.8 times more in Wyoming 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· 29th 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.