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 $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $407.38 | Professional | None | $398.11 | $398.11 | $407.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $478.63 | Professional | None | $117.49 | $147.91 | $478.63 |
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 $398.11 Median $467.74 Typical High $537.03 | Facility | None | $398.11 | $467.74 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $478.63 | Professional | None | $177.83 | $213.80 | $478.63 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $83.18 Typical High $331.13 | Professional | None | $30.20 | $83.18 | $331.13 |
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 $194.98 Median $194.98 Typical High $204.17 | Professional | 52 · Reduced service | $194.98 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | 53 · Discontinued | $79.43 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $61.66 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $40.74 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $40.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $107.15 Typical High $123.03 | Professional | 51 · Multiple procedures | $107.15 | $107.15 | $123.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $42.66 Typical High $48.98 | Professional | 80 · Assistant surgeon | $42.66 | $42.66 | $48.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $30.20 Median $30.20 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $30.20 | $30.20 | $33.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $30.20 Median $30.20 Typical High $33.88 | Professional | 82 · Assistant surgeon, no resident | $30.20 | $30.20 | $33.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $30.20 Median $30.20 Typical High $33.88 | Professional | AS · PA/NP assist | $30.20 | $30.20 | $33.88 |
Where South Carolina sits
The same service costs 4.1 times more in Alaska 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· 26th 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.