How much rates vary
Facilitymedian $200 · 10th to 90th $76 to $1,202Professionalmedian $100 · 10th to 90th $55 to $178
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 $64.57 Median $147.91 Typical High $21,877.62 | Facility | None | $64.57 | $147.91 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $177.83 | Professional | None | $64.57 | $95.50 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
BCBS South Carolina Setting Facility Modifier None Typical Low $134.90 Median $229.09 Typical High $416.87 | Facility | None | $134.90 | $229.09 | $416.87 |
BCBS South Carolina Setting Professional Modifier None Typical Low $46.77 Median $100.00 Typical High $131.83 | Professional | None | $46.77 | $100.00 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $794.33 | Facility | None | $52.48 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $93.33 Typical High $177.83 | Professional | None | $54.95 | $93.33 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $162.18 | Facility | None | $43.65 | $69.18 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $154.88 | Professional | None | $102.33 | $128.82 | $154.88 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $229.09 | Professional | None | $125.89 | $154.88 | $229.09 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $53.70 Median $100.00 Typical High $173.78 | Professional | None | $53.70 | $100.00 | $173.78 |
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 $32.36 Median $32.36 Typical High $74.13 | Professional | 52 · Reduced service | $32.36 | $32.36 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $29.51 | Professional | 53 · Discontinued | $12.88 | $12.88 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $48.98 Typical High $112.20 | Professional | 54 · Surgery only | $48.98 | $48.98 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $22.39 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $14.79 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $51.29 Median $64.57 Typical High $97.72 | Professional | 51 · Multiple procedures | $51.29 | $64.57 | $97.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $20.42 Median $25.70 Typical High $38.90 | Professional | 80 · Assistant surgeon | $20.42 | $25.70 | $38.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $14.13 Median $18.20 Typical High $27.54 | Professional | 81 · Minimal assistant surgeon | $14.13 | $18.20 | $27.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $14.13 Median $18.20 Typical High $27.54 | Professional | 82 · Assistant surgeon, no resident | $14.13 | $18.20 | $27.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $14.13 Median $18.20 Typical High $27.54 | Professional | AS · PA/NP assist | $14.13 | $18.20 | $27.54 |
Where South Carolina sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 44th of 51
$102
AK $302NJ $85.11
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.