How much rates vary
Facilitymedian $162 · 10th to 90th $76 to $1,175Professionalmedian $81 · 10th to 90th $38 to $141
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 $50.12 Median $125.89 Typical High $21,877.62 | Facility | None | $50.12 | $125.89 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $87.10 Typical High $141.25 | Professional | None | $50.12 | $87.10 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $131.83 | Professional | None | $89.13 | $89.13 | $131.83 |
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 $35.48 Median $72.44 Typical High $112.20 | Professional | None | $35.48 | $72.44 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $154.88 | Facility | None | $75.86 | $100.00 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $70.79 Typical High $141.25 | Professional | None | $38.02 | $70.79 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $141.25 | Facility | None | $43.65 | $69.18 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $131.83 | Professional | None | $79.43 | $100.00 | $131.83 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $169.82 | Professional | None | $95.50 | $117.49 | $169.82 |
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 $38.90 Median $77.62 Typical High $134.90 | Professional | None | $38.90 | $77.62 | $134.90 |
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 $25.12 Median $25.12 Typical High $63.10 | Professional | 52 · Reduced service | $25.12 | $25.12 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $25.12 | Professional | 53 · Discontinued | $10.00 | $10.00 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $37.15 Typical High $93.33 | Professional | 54 · Surgery only | $37.15 | $37.15 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $18.62 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $12.59 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $12.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $39.81 Median $50.12 Typical High $83.18 | Professional | 51 · Multiple procedures | $39.81 | $50.12 | $83.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.85 Median $19.95 Typical High $33.11 | Professional | 80 · Assistant surgeon | $15.85 | $19.95 | $33.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.96 Median $13.80 Typical High $22.91 | Professional | 81 · Minimal assistant surgeon | $10.96 | $13.80 | $22.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.96 Median $13.80 Typical High $22.91 | Professional | 82 · Assistant surgeon, no resident | $10.96 | $13.80 | $22.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.96 Median $13.80 Typical High $22.91 | Professional | AS · PA/NP assist | $10.96 | $13.80 | $22.91 |
Where South Carolina sits
The same service costs 3.5 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· 43rd of 51
$85.11
AK $229KY $66.07
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.