How much rates vary
Facilitymedian $251 · 10th to 90th $69 to $1,175Professionalmedian $76 · 10th to 90th $43 to $120
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 $56.23 Median $87.10 Typical High $21,877.62 | Facility | None | $56.23 | $87.10 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $64.57 Typical High $87.10 | Professional | None | $56.23 | $64.57 | $87.10 |
BCBS South Carolina Setting Facility Modifier None Typical Low $213.80 Median $407.38 Typical High $660.69 | Facility | None | $213.80 | $407.38 | $660.69 |
BCBS South Carolina Setting Professional Modifier None Typical Low $42.66 Median $83.18 Typical High $83.18 | Professional | None | $42.66 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $75.86 Typical High $151.36 | Facility | None | $61.66 | $75.86 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $67.61 Typical High $100.00 | Professional | None | $43.65 | $67.61 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Medcost Setting Facility Modifier None Typical Low $45.71 Median $70.79 Typical High $97.72 | Facility | None | $45.71 | $70.79 | $97.72 |
Medcost Setting Professional Modifier None Typical Low $81.28 Median $93.33 Typical High $151.36 | Professional | None | $81.28 | $93.33 | $151.36 |
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 $43.65 Median $66.07 Typical High $125.89 | Professional | None | $43.65 | $66.07 | $125.89 |
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 $28.18 Median $28.18 Typical High $43.65 | Professional | 52 · Reduced service | $28.18 | $28.18 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $17.78 | Professional | 53 · Discontinued | $11.22 | $11.22 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $42.66 Typical High $66.07 | Professional | 54 · Surgery only | $42.66 | $42.66 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $13.18 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $8.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $40.74 Median $51.29 Typical High $75.86 | Professional | 51 · Multiple procedures | $40.74 | $51.29 | $75.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.22 Median $20.42 Typical High $30.20 | Professional | 80 · Assistant surgeon | $16.22 | $20.42 | $30.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.48 Median $14.13 Typical High $21.38 | Professional | 81 · Minimal assistant surgeon | $11.48 | $14.13 | $21.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.48 Median $14.13 Typical High $21.38 | Professional | 82 · Assistant surgeon, no resident | $11.48 | $14.13 | $21.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $11.48 Median $14.13 Typical High $21.38 | Professional | AS · PA/NP assist | $11.48 | $14.13 | $21.38 |
Where South Carolina sits
The same service costs 3.4 times more in Alaska than in New York. 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· 23rd of 51
$83.18
AK $209NY $61.66
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.