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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | None | $89.13 | $93.33 | $93.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $147.91 | Professional | None | $117.49 | $147.91 | $147.91 |
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 $93.33 Median $109.65 Typical High $389.05 | Facility | None | $93.33 | $109.65 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $208.93 | Professional | None | $151.36 | $151.36 | $208.93 |
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 $44.67 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $44.67 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $17.78 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $13.18 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.91 | $9.33 | $9.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $75.86 Median $75.86 Typical High $141.25 | Professional | 51 · Multiple procedures | $75.86 | $75.86 | $141.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.20 Median $30.20 Typical High $56.23 | Professional | 80 · Assistant surgeon | $30.20 | $30.20 | $56.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $20.89 Median $20.89 Typical High $38.90 | Professional | 81 · Minimal assistant surgeon | $20.89 | $20.89 | $38.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $20.89 Median $20.89 Typical High $38.90 | Professional | 82 · Assistant surgeon, no resident | $20.89 | $20.89 | $38.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $20.89 Median $20.89 Typical High $38.90 | Professional | AS · PA/NP assist | $20.89 | $20.89 | $38.90 |
Where South Carolina sits
The same service costs 1.9 times more in Alaska than in New York. 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· 10th 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.