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 $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $489.78 | Professional | None | $457.09 | $467.74 | $489.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $1,479.11 | Professional | None | $117.49 | $147.91 | $1,479.11 |
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 $467.74 Median $562.34 Typical High $1,380.38 | Facility | None | $467.74 | $562.34 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,288.25 | $1,318.26 | $1,380.38 |
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 $229.09 Median $234.42 Typical High $245.47 | Professional | 52 · Reduced service | $229.09 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $93.33 Typical High $97.72 | Professional | 53 · Discontinued | $91.20 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $67.61 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $46.77 Typical High $48.98 | Professional | 56 · Pre-op care only | $45.71 | $46.77 | $48.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $660.69 Typical High $912.01 | Professional | 51 · Multiple procedures | $562.34 | $660.69 | $912.01 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $263.03 Typical High $363.08 | Professional | 80 · Assistant surgeon | $223.87 | $263.03 | $363.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $181.97 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $158.49 | $181.97 | $251.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $181.97 Typical High $251.19 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $181.97 | $251.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $181.97 Typical High $251.19 | Professional | AS · PA/NP assist | $158.49 | $181.97 | $251.19 |
Where South Carolina sits
The same service costs 10.0 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· 35th 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.