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 $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $354.81 | Professional | None | $114.82 | $114.82 | $354.81 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $478.63 | Professional | None | $117.49 | $147.91 | $478.63 |
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 $114.82 Median $138.04 Typical High $478.63 | Facility | None | $114.82 | $138.04 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $331.13 Typical High $478.63 | Professional | None | $323.59 | $331.13 | $478.63 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $398.11 | Professional | None | $83.18 | $104.71 | $398.11 |
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 $57.54 Median $57.54 Typical High $177.83 | Professional | 52 · Reduced service | $57.54 | $57.54 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $70.79 | Professional | 53 · Discontinued | $22.91 | $22.91 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $53.70 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $35.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $162.18 Median $162.18 Typical High $302.00 | Professional | 51 · Multiple procedures | $162.18 | $162.18 | $302.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $64.57 Typical High $120.23 | Professional | 80 · Assistant surgeon | $64.57 | $64.57 | $120.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $45.71 Median $45.71 Typical High $83.18 | Professional | 81 · Minimal assistant surgeon | $45.71 | $45.71 | $83.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $45.71 Median $45.71 Typical High $83.18 | Professional | 82 · Assistant surgeon, no resident | $45.71 | $45.71 | $83.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $45.71 Typical High $83.18 | Professional | AS · PA/NP assist | $45.71 | $45.71 | $83.18 |
Where South Carolina sits
The same service costs 4.1 times more in Alaska 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
$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.