How much rates vary
Facilitymedian $162 · 10th to 90th $76 to $1,175Professionalmedian $117 · 10th to 90th $59 to $182
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 $69.18 Median $151.36 Typical High $21,877.62 | Facility | None | $69.18 | $151.36 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $177.83 | Professional | None | $69.18 | $95.50 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $134.90 Median $223.87 Typical High $416.87 | Facility | None | $134.90 | $223.87 | $416.87 |
BCBS South Carolina Setting Professional Modifier None Typical Low $50.12 Median $120.23 Typical High $154.88 | Professional | None | $50.12 | $120.23 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $104.71 Typical High $162.18 | Facility | None | $75.86 | $104.71 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $181.97 | Professional | None | $58.88 | $95.50 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Medcost Setting Facility Modifier None Typical Low $51.29 Median $69.18 Typical High $169.82 | Facility | None | $51.29 | $69.18 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $158.49 | Professional | None | $100.00 | $128.82 | $158.49 |
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 $56.23 Median $102.33 Typical High $177.83 | Professional | None | $56.23 | $102.33 | $177.83 |
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 $34.67 Median $34.67 Typical High $75.86 | Professional | 52 · Reduced service | $34.67 | $34.67 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $30.20 | Professional | 53 · Discontinued | $13.80 | $13.80 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $51.29 Typical High $112.20 | Professional | 54 · Surgery only | $51.29 | $51.29 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $22.39 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $15.14 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $15.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $50.12 Median $64.57 Typical High $100.00 | Professional | 51 · Multiple procedures | $50.12 | $64.57 | $100.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $20.42 Median $25.70 Typical High $39.81 | Professional | 80 · Assistant surgeon | $20.42 | $25.70 | $39.81 |
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 3.1 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· 28th of 51
$120
AK $269KY $87.10
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.