How much rates vary
Facilitymedian $182 · 10th to 90th $83 to $1,175Professionalmedian $123 · 10th to 90th $63 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 $81.28 Median $169.82 Typical High $21,877.62 | Facility | None | $81.28 | $169.82 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $199.53 | Professional | None | $79.43 | $112.20 | $199.53 |
BCBS South Carolina Setting Facility Modifier None Typical Low $134.90 Median $245.47 Typical High $426.58 | Facility | None | $134.90 | $245.47 | $426.58 |
BCBS South Carolina Setting Professional Modifier None Typical Low $58.88 Median $123.03 Typical High $162.18 | Professional | None | $58.88 | $123.03 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $120.23 Typical High $190.55 | Facility | None | $75.86 | $120.23 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $102.33 Typical High $204.17 | Professional | None | $63.10 | $102.33 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $204.17 | Facility | None | $66.07 | $102.33 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $177.83 | Professional | None | $114.82 | $144.54 | $177.83 |
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 $114.82 Typical High $204.17 | Professional | None | $63.10 | $114.82 | $204.17 |
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 $40.74 Median $40.74 Typical High $85.11 | Professional | 52 · Reduced service | $40.74 | $40.74 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $33.88 | Professional | 53 · Discontinued | $16.22 | $16.22 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $125.89 | Professional | 54 · Surgery only | $61.66 | $61.66 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $25.12 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $16.98 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $16.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $72.44 Typical High $112.20 | Professional | 51 · Multiple procedures | $57.54 | $72.44 | $112.20 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $22.91 Median $28.84 Typical High $44.67 | Professional | 80 · Assistant surgeon | $22.91 | $28.84 | $44.67 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.85 Median $20.42 Typical High $30.90 | Professional | 81 · Minimal assistant surgeon | $15.85 | $20.42 | $30.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.85 Median $20.42 Typical High $30.90 | Professional | 82 · Assistant surgeon, no resident | $15.85 | $20.42 | $30.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.85 Median $20.42 Typical High $30.90 | Professional | AS · PA/NP assist | $15.85 | $20.42 | $30.90 |
Where South Carolina sits
The same service costs 3.2 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· 27th of 51
$135
AK $309KY $97.72
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.