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 $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | None | $912.01 | $954.99 | $954.99 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $912.01 | Professional | None | $117.49 | $147.91 | $912.01 |
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 $954.99 Median $1,148.15 Typical High $1,659.59 | Facility | None | $954.99 | $1,148.15 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,659.59 | Professional | None | $660.69 | $660.69 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
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 $457.09 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $457.09 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $181.97 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $91.20 | $95.50 | $95.50 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $331.13 Typical High $512.86 | Professional | 51 · Multiple procedures | $316.23 | $331.13 | $512.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $131.83 Typical High $204.17 | Professional | 80 · Assistant surgeon | $125.89 | $131.83 | $204.17 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $89.13 Median $93.33 Typical High $141.25 | Professional | 81 · Minimal assistant surgeon | $89.13 | $93.33 | $141.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $89.13 Median $93.33 Typical High $141.25 | Professional | 82 · Assistant surgeon, no resident | $89.13 | $93.33 | $141.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $93.33 Typical High $141.25 | Professional | AS · PA/NP assist | $89.13 | $93.33 | $141.25 |
Where South Carolina sits
The same service costs 12.0 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.