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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $128.82 | Professional | None | $123.03 | $123.03 | $128.82 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $151.36 | Professional | None | $117.49 | $147.91 | $151.36 |
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 $123.03 Median $131.83 Typical High $165.96 | Facility | None | $123.03 | $131.83 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $177.83 | Professional | None | $141.25 | $141.25 | $177.83 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $83.18 Typical High $123.03 | Professional | None | $30.20 | $83.18 | $123.03 |
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 $61.66 Median $61.66 Typical High $63.10 | Professional | 52 · Reduced service | $61.66 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $25.70 | Professional | 53 · Discontinued | $24.55 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $19.05 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $12.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $70.79 Median $70.79 Typical High $123.03 | Professional | 51 · Multiple procedures | $70.79 | $70.79 | $123.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.18 Median $28.18 Typical High $48.98 | Professional | 80 · Assistant surgeon | $28.18 | $28.18 | $48.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.95 Median $19.95 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $19.95 | $19.95 | $33.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.95 Median $19.95 Typical High $33.88 | Professional | 82 · Assistant surgeon, no resident | $19.95 | $19.95 | $33.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.95 Median $19.95 Typical High $33.88 | Professional | AS · PA/NP assist | $19.95 | $19.95 | $33.88 |
Where South Carolina sits
The same service costs 1.7 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· 25th 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.