How much rates vary
Facilitymedian $457 · 10th to 90th $66 to $2,570Professionalmedian $71 · 10th to 90th $49 to $123
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 $54.95 Median $85.11 Typical High $10,000.00 | Facility | None | $54.95 | $85.11 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $58.88 Typical High $81.28 | Professional | None | $50.12 | $58.88 | $81.28 |
Ambetter Setting Professional Modifier None Typical Low $35.48 Median $45.71 Typical High $69.18 | Professional | None | $35.48 | $45.71 | $69.18 |
BCBS South Carolina Setting Professional Modifier None Typical Low $41.69 Median $70.79 Typical High $104.71 | Professional | None | $41.69 | $70.79 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $1,905.46 | Facility | None | $588.84 | $851.14 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $75.86 Typical High $120.23 | Professional | None | $63.10 | $75.86 | $120.23 |
Medcost Setting Facility Modifier None Typical Low $52.48 Median $66.07 Typical High $138.04 | Facility | None | $52.48 | $66.07 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $87.10 | Professional | None | $58.88 | $81.28 | $87.10 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $125.89 | Professional | None | $64.57 | $89.13 | $125.89 |
United Setting Facility Modifier None Typical Low $83.18 Median $426.58 Typical High $2,238.72 | Facility | None | $83.18 | $426.58 | $2,238.72 |
United Setting Professional Modifier None Typical Low $48.98 Median $66.07 Typical High $120.23 | Professional | None | $48.98 | $66.07 | $120.23 |
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 $24.55 Median $27.54 Typical High $33.11 | Professional | 52 · Reduced service | $24.55 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.96 Typical High $13.18 | Professional | 53 · Discontinued | $10.00 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $40.74 Typical High $48.98 | Professional | 54 · Surgery only | $38.02 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.32 Typical High $9.77 | Professional | 55 · Aftercare only | $7.41 | $8.32 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.50 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.01 | $5.50 | $6.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $38.02 Median $40.74 Typical High $54.95 | Professional | 51 · Multiple procedures | $38.02 | $40.74 | $54.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.49 Median $16.22 Typical High $21.88 | Professional | 80 · Assistant surgeon | $15.49 | $16.22 | $21.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.72 Median $11.48 Typical High $15.49 | Professional | 81 · Minimal assistant surgeon | $10.72 | $11.48 | $15.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.72 Median $11.48 Typical High $15.49 | Professional | 82 · Assistant surgeon, no resident | $10.72 | $11.48 | $15.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.72 Median $11.48 Typical High $15.49 | Professional | AS · PA/NP assist | $10.72 | $11.48 | $15.49 |
Where South Carolina sits
The same service costs 4.8 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· 26th of 51
$74.13
AK $240KY $50.12
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.