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 $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $575.44 Typical High $602.56 | Professional | None | $562.34 | $575.44 | $602.56 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $1,000.00 | Professional | None | $117.49 | $147.91 | $1,000.00 |
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 $575.44 Median $691.83 Typical High $1,584.89 | Facility | None | $575.44 | $691.83 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,258.93 | Professional | None | $602.56 | $602.56 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
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 $281.84 Median $288.40 Typical High $302.00 | Professional | 52 · Reduced service | $281.84 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $117.49 Typical High $120.23 | Professional | 53 · Discontinued | $112.20 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $87.10 Typical High $91.20 | Professional | 55 · Aftercare only | $83.18 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $57.54 Typical High $60.26 | Professional | 56 · Pre-op care only | $56.23 | $57.54 | $60.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $302.00 Typical High $660.69 | Professional | 51 · Multiple procedures | $302.00 | $302.00 | $660.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $123.03 Typical High $263.03 | Professional | 80 · Assistant surgeon | $123.03 | $123.03 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $85.11 Median $85.11 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $85.11 | $85.11 | $181.97 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $85.11 Median $85.11 Typical High $181.97 | Professional | 82 · Assistant surgeon, no resident | $85.11 | $85.11 | $181.97 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $85.11 Typical High $181.97 | Professional | AS · PA/NP assist | $85.11 | $85.11 | $181.97 |
Where South Carolina sits
The same service costs 9.1 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· 33rd 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.