How much rates vary
Facilitymedian $603 · 10th to 90th $76 to $2,951Professionalmedian $186 · 10th to 90th $54 to $282
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 $58.88 Median $4,897.79 Typical High $21,877.62 | Facility | None | $58.88 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $151.36 Typical High $239.88 | Professional | None | $58.88 | $151.36 | $239.88 |
BCBS South Carolina Setting Professional Modifier None Typical Low $42.66 Median $77.62 Typical High $204.17 | Professional | None | $42.66 | $77.62 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $891.25 Typical High $1,995.26 | Facility | None | $602.56 | $891.25 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $147.91 Typical High $257.04 | Professional | None | $61.66 | $147.91 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $47.86 Median $141.25 Typical High $354.81 | Facility | None | $47.86 | $141.25 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $575.44 | Professional | None | $190.55 | $239.88 | $575.44 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $346.74 | Professional | None | $190.55 | $234.42 | $346.74 |
United Setting Facility Modifier None Typical Low $83.18 Median $426.58 Typical High $2,238.72 | Facility | None | $83.18 | $426.58 | $2,238.72 |
United Setting Professional Modifier None Typical Low $46.77 Median $134.90 Typical High $263.03 | Professional | None | $46.77 | $134.90 | $263.03 |
11 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 $29.51 Median $40.74 Typical High $120.23 | Professional | 52 · Reduced service | $29.51 | $40.74 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $16.22 Typical High $47.86 | Professional | 53 · Discontinued | $11.75 | $16.22 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $61.66 Typical High $181.97 | Professional | 54 · Surgery only | $43.65 | $61.66 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.30 Typical High $36.31 | Professional | 55 · Aftercare only | $8.71 | $12.30 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.13 Typical High $23.99 | Professional | 56 · Pre-op care only | $5.89 | $8.13 | $23.99 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $288.40 Median $457.09 Typical High $851.14 | Professional | 50 · Both sides | $288.40 | $457.09 | $851.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $151.36 Typical High $281.84 | Professional | 51 · Multiple procedures | $95.50 | $151.36 | $281.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.02 Median $60.26 Typical High $114.82 | Professional | 80 · Assistant surgeon | $38.02 | $60.26 | $114.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $26.92 Median $42.66 Typical High $79.43 | Professional | 81 · Minimal assistant surgeon | $26.92 | $42.66 | $79.43 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $26.92 Median $42.66 Typical High $79.43 | Professional | 82 · Assistant surgeon, no resident | $26.92 | $42.66 | $79.43 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $26.92 Median $42.66 Typical High $79.43 | Professional | AS · PA/NP assist | $26.92 | $42.66 | $79.43 |
Where South Carolina sits
The same service costs 4.6 times more in Iowa 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· 16th of 51
$191
IA $288KY $63.10
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.