How much rates vary
Facilitymedian $490 · 10th to 90th $79 to $1,096Professionalmedian $110 · 10th to 90th $60 to $186
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 $60.26 Median $4,897.79 Typical High $21,877.62 | Facility | None | $60.26 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $147.91 | Professional | None | $60.26 | $100.00 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $275.42 Median $537.03 Typical High $794.33 | Facility | None | $275.42 | $537.03 | $794.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $44.67 Median $95.50 Typical High $144.54 | Professional | None | $44.67 | $95.50 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $79.43 Typical High $151.36 | Facility | None | $69.18 | $79.43 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $194.98 | Professional | None | $74.13 | $125.89 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $117.49 Typical High $147.91 | Facility | None | $66.07 | $117.49 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $169.82 | Professional | None | $95.50 | $147.91 | $169.82 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $190.55 | Professional | None | $95.50 | $138.04 | $190.55 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $54.95 Median $100.00 Typical High $208.93 | Professional | None | $54.95 | $100.00 | $208.93 |
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 $29.51 Median $30.90 Typical High $54.95 | Professional | 52 · Reduced service | $29.51 | $30.90 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.30 Typical High $21.88 | Professional | 53 · Discontinued | $11.75 | $12.30 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $46.77 Typical High $83.18 | Professional | 54 · Surgery only | $43.65 | $46.77 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $16.60 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.17 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.89 | $6.17 | $10.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $61.66 Median $74.13 Typical High $95.50 | Professional | 51 · Multiple procedures | $61.66 | $74.13 | $95.50 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $27.54 Median $29.51 Typical High $38.90 | Professional | 80 · Assistant surgeon | $27.54 | $29.51 | $38.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.50 Median $20.89 Typical High $26.92 | Professional | 81 · Minimal assistant surgeon | $19.50 | $20.89 | $26.92 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.50 Median $20.89 Typical High $26.92 | Professional | 82 · Assistant surgeon, no resident | $19.50 | $20.89 | $26.92 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.50 Median $20.89 Typical High $26.92 | Professional | AS · PA/NP assist | $19.50 | $20.89 | $26.92 |
Where South Carolina sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 24th of 51
$117
AK $257PA $93.33
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.