How much rates vary
Facilitymedian $617 · 10th to 90th $81 to $2,951Professionalmedian $245 · 10th to 90th $79 to $427
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 $79.43 Median $4,897.79 Typical High $21,877.62 | Facility | None | $79.43 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $257.04 | Professional | None | $79.43 | $173.78 | $257.04 |
BCBS South Carolina Setting Professional Modifier None Typical Low $64.57 Median $165.96 Typical High $407.38 | Professional | None | $64.57 | $165.96 | $407.38 |
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 $104.71 Median $263.03 Typical High $457.09 | Professional | None | $104.71 | $263.03 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $75.86 Median $199.53 Typical High $346.74 | Facility | None | $75.86 | $199.53 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $380.19 | Professional | None | $269.15 | $371.54 | $380.19 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $446.68 | Professional | None | $223.87 | $323.59 | $446.68 |
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 $81.28 Median $218.78 Typical High $489.78 | Professional | None | $81.28 | $218.78 | $489.78 |
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 $39.81 Median $45.71 Typical High $128.82 | Professional | 52 · Reduced service | $39.81 | $45.71 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $18.20 Typical High $51.29 | Professional | 53 · Discontinued | $15.85 | $18.20 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $67.61 Typical High $190.55 | Professional | 54 · Surgery only | $58.88 | $67.61 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.49 Typical High $38.02 | Professional | 55 · Aftercare only | $11.75 | $13.49 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.12 Typical High $25.70 | Professional | 56 · Pre-op care only | $7.94 | $9.12 | $25.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $186.21 Typical High $251.19 | Professional | 51 · Multiple procedures | $158.49 | $186.21 | $251.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $74.13 Typical High $100.00 | Professional | 80 · Assistant surgeon | $64.57 | $74.13 | $100.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $44.67 Median $52.48 Typical High $70.79 | Professional | 81 · Minimal assistant surgeon | $44.67 | $52.48 | $70.79 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $44.67 Median $52.48 Typical High $70.79 | Professional | 82 · Assistant surgeon, no resident | $44.67 | $52.48 | $70.79 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $44.67 Median $52.48 Typical High $70.79 | Professional | AS · PA/NP assist | $44.67 | $52.48 | $70.79 |
Where South Carolina sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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
$257
OK $575NE $129
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.