How much rates vary
Facilitymedian $324 · 10th to 90th $81 to $1,585Professionalmedian $138 · 10th to 90th $65 to $195
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 $77.62 Median $165.96 Typical High $21,877.62 | Facility | None | $77.62 | $165.96 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $112.20 Typical High $194.98 | Professional | None | $75.86 | $112.20 | $194.98 |
BCBS South Carolina Setting Facility Modifier None Typical Low $239.88 Median $416.87 Typical High $707.95 | Facility | None | $239.88 | $416.87 | $707.95 |
BCBS South Carolina Setting Professional Modifier None Typical Low $56.23 Median $138.04 Typical High $169.82 | Professional | None | $56.23 | $138.04 | $169.82 |
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 $64.57 Median $109.65 Typical High $194.98 | Professional | None | $64.57 | $109.65 | $194.98 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $181.97 | Facility | None | $66.07 | $102.33 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $173.78 | Professional | None | $123.03 | $141.25 | $173.78 |
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 $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $63.10 Median $109.65 Typical High $199.53 | Professional | None | $63.10 | $109.65 | $199.53 |
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 $38.90 Median $38.90 Typical High $81.28 | Professional | 52 · Reduced service | $38.90 | $38.90 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $33.11 | Professional | 53 · Discontinued | $15.49 | $15.49 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $123.03 | Professional | 54 · Surgery only | $57.54 | $57.54 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $24.55 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $16.60 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $16.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $61.66 Median $70.79 Typical High $107.15 | Professional | 51 · Multiple procedures | $61.66 | $70.79 | $107.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $24.55 Median $28.18 Typical High $43.65 | Professional | 80 · Assistant surgeon | $24.55 | $28.18 | $43.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.98 Median $19.95 Typical High $30.20 | Professional | 81 · Minimal assistant surgeon | $16.98 | $19.95 | $30.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.98 Median $19.95 Typical High $30.20 | Professional | 82 · Assistant surgeon, no resident | $16.98 | $19.95 | $30.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.98 Median $19.95 Typical High $30.20 | Professional | AS · PA/NP assist | $16.98 | $19.95 | $30.20 |
Where South Carolina sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 25th of 51
$138
AK $355MD $100
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.