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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | None | $147.91 | $147.91 | $151.36 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $181.97 | Professional | None | $117.49 | $147.91 | $181.97 |
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 $147.91 Median $177.83 Typical High $199.53 | Facility | None | $147.91 | $177.83 | $199.53 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $181.97 | Professional | None | $125.89 | $125.89 | $181.97 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $147.91 | Professional | None | $83.18 | $104.71 | $147.91 |
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 $74.13 Median $74.13 Typical High $75.86 | Professional | 52 · Reduced service | $74.13 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $30.90 | Professional | 53 · Discontinued | $29.51 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $22.91 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $15.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $63.10 Typical High $123.03 | Professional | 51 · Multiple procedures | $63.10 | $63.10 | $123.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.12 Median $25.12 Typical High $48.98 | Professional | 80 · Assistant surgeon | $25.12 | $25.12 | $48.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.78 Median $17.78 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $17.78 | $17.78 | $33.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.78 Median $17.78 Typical High $33.88 | Professional | 82 · Assistant surgeon, no resident | $17.78 | $17.78 | $33.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.78 Median $17.78 Typical High $33.88 | Professional | AS · PA/NP assist | $17.78 | $17.78 | $33.88 |
Where South Carolina sits
The same service costs 2.4 times more in Alaska than in Kentucky. 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· 18th 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.