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 $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier None Typical Low $2,951.21 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,951.21 | $3,019.95 | $3,019.95 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $575.44 | Professional | None | $117.49 | $147.91 | $575.44 |
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 $3,019.95 Median $3,630.78 Typical High $4,073.80 | Facility | None | $3,019.95 | $3,630.78 | $4,073.80 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $3,715.35 | Professional | None | $524.81 | $524.81 | $3,715.35 |
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 $1,479.11 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,479.11 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $602.56 Typical High $616.60 | Professional | 53 · Discontinued | $588.84 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $446.68 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $295.12 | $302.00 | $302.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $263.03 Typical High $489.78 | Professional | 51 · Multiple procedures | $263.03 | $263.03 | $489.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $107.15 Typical High $194.98 | Professional | 80 · Assistant surgeon | $107.15 | $107.15 | $194.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $74.13 Median $74.13 Typical High $138.04 | Professional | 81 · Minimal assistant surgeon | $74.13 | $74.13 | $138.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $74.13 Median $74.13 Typical High $138.04 | Professional | 82 · Assistant surgeon, no resident | $74.13 | $74.13 | $138.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $74.13 Typical High $138.04 | Professional | AS · PA/NP assist | $74.13 | $74.13 | $138.04 |
Where South Carolina sits
The same service costs 26.9 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.