How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,479 to $18,197Professionalmedian $1,122 · 10th to 90th $1,023 to $1,950
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $1,122.02 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,122.02 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,174.90 | Professional | None | $1,122.02 | $1,122.02 | $1,174.90 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,951.21 Typical High $14,125.38 | Facility | None | $1,778.28 | $2,951.21 | $14,125.38 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,011.87 Typical High $7,244.36 | Facility | None | $602.56 | $5,011.87 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $8,511.38 | Facility | None | $1,122.02 | $1,348.96 | $8,511.38 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,122.02 | $1,584.89 |
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 Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,288.25 | $2,238.72 |
10 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 $562.34 Median $562.34 Typical High $588.84 | Professional | 52 · Reduced service | $562.34 | $562.34 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $234.42 | Professional | 53 · Discontinued | $223.87 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $891.25 | Professional | 54 · Surgery only | $851.14 | $851.14 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $177.83 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $117.49 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $117.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $562.34 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $562.34 | $562.34 | $1,047.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $229.09 Typical High $426.58 | Professional | 80 · Assistant surgeon | $229.09 | $229.09 | $426.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $158.49 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $158.49 | $158.49 | $295.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $158.49 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $158.49 | $295.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $158.49 Typical High $295.12 | Professional | AS · PA/NP assist | $158.49 | $158.49 | $295.12 |
Where South Carolina sits
The same service costs 5.9 times more in Texas 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· 32nd of 51
$1,738
TX $5,754KY $977
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.