How much rates vary
Facilitymedian $955 · 10th to 90th $123 to $3,890Professionalmedian $145 · 10th to 90th $87 to $204
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 $102.33 Median $4,897.79 Typical High $21,877.62 | Facility | None | $102.33 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $158.49 | Professional | None | $100.00 | $131.83 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $234.42 Typical High $234.42 | Professional | None | $125.89 | $234.42 | $234.42 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,202.26 Typical High $2,089.30 | Facility | None | $691.83 | $1,202.26 | $2,089.30 |
BCBS South Carolina Setting Professional Modifier None Typical Low $77.62 Median $165.96 Typical High $204.17 | Professional | None | $77.62 | $165.96 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $194.98 Typical High $707.95 | Facility | None | $89.13 | $194.98 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $186.21 | Professional | None | $87.10 | $128.82 | $186.21 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $128.82 Typical High $173.78 | Facility | None | $91.20 | $128.82 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $186.21 | Professional | None | $134.90 | $165.96 | $186.21 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $229.09 | Professional | None | $128.82 | $158.49 | $229.09 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,025.60 | Facility | None | $302.00 | $1,122.02 | $6,025.60 |
United Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $234.42 | Professional | None | $81.28 | $125.89 | $234.42 |
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 $51.29 Median $51.29 Typical High $77.62 | Professional | 52 · Reduced service | $51.29 | $51.29 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $31.62 | Professional | 53 · Discontinued | $20.42 | $20.42 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $117.49 | Professional | 54 · Surgery only | $75.86 | $75.86 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $23.44 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $15.85 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $67.61 Median $87.10 Typical High $102.33 | Professional | 51 · Multiple procedures | $67.61 | $87.10 | $102.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.92 Median $35.48 Typical High $41.69 | Professional | 80 · Assistant surgeon | $26.92 | $35.48 | $41.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.05 Median $24.55 Typical High $28.84 | Professional | 81 · Minimal assistant surgeon | $19.05 | $24.55 | $28.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.05 Median $24.55 Typical High $28.84 | Professional | 82 · Assistant surgeon, no resident | $19.05 | $24.55 | $28.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.05 Median $24.55 Typical High $28.84 | Professional | AS · PA/NP assist | $19.05 | $24.55 | $28.84 |
Where South Carolina sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$158
AK $372FL $117
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.