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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,445.44 | $1,513.56 | $1,513.56 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $1,621.81 | Professional | None | $117.49 | $147.91 | $1,621.81 |
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 $1,513.56 Median $1,819.70 Typical High $3,019.95 | Facility | None | $1,513.56 | $1,819.70 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $3,019.95 | Professional | None | $269.15 | $269.15 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $229.09 Typical High $2,454.71 | Professional | None | $83.18 | $229.09 | $2,454.71 |
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 $724.44 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $724.44 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $288.40 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $218.78 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $151.36 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $134.90 Typical High $1,659.59 | Professional | 51 · Multiple procedures | $134.90 | $134.90 | $1,659.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $53.70 Typical High $660.69 | Professional | 80 · Assistant surgeon | $53.70 | $53.70 | $660.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $37.15 Median $37.15 Typical High $467.74 | Professional | 81 · Minimal assistant surgeon | $37.15 | $37.15 | $467.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $37.15 Median $37.15 Typical High $467.74 | Professional | 82 · Assistant surgeon, no resident | $37.15 | $37.15 | $467.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $37.15 Typical High $467.74 | Professional | AS · PA/NP assist | $37.15 | $37.15 | $467.74 |
Where South Carolina sits
The same service costs 21.9 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.