How much rates vary
Facilitymedian $204 · 10th to 90th $71 to $1,122Professionalmedian $74 · 10th to 90th $17 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 $18.62 Median $18.62 Typical High $91.20 | Facility | None | $18.62 | $18.62 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $29.51 Typical High $91.20 | Professional | None | $18.62 | $29.51 | $91.20 |
BCBS South Carolina Setting Facility Modifier None Typical Low $169.82 Median $288.40 Typical High $512.86 | Facility | None | $169.82 | $288.40 | $512.86 |
BCBS South Carolina Setting Professional Modifier None Typical Low $13.18 Median $69.18 Typical High $165.96 | Professional | None | $13.18 | $69.18 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $79.43 Typical High $724.44 | Facility | None | $69.18 | $79.43 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $74.13 Typical High $114.82 | Professional | None | $21.38 | $74.13 | $114.82 |
Medcost Setting Facility Modifier None Typical Low $18.62 Median $51.29 Typical High $114.82 | Facility | None | $18.62 | $51.29 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $107.15 | Professional | None | $89.13 | $89.13 | $107.15 |
Molina Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $112.20 | Professional | None | $61.66 | $77.62 | $112.20 |
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 $14.45 Median $56.23 Typical High $117.49 | Professional | None | $14.45 | $56.23 | $117.49 |
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 $9.33 Median $12.88 Typical High $45.71 | Professional | 52 · Reduced service | $9.33 | $12.88 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $5.13 Typical High $18.20 | Professional | 53 · Discontinued | $3.72 | $5.13 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.89 Typical High $13.80 | Professional | 55 · Aftercare only | $2.82 | $3.89 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $5.75 Typical High $9.12 | Professional | 56 · Pre-op care only | $1.86 | $5.75 | $9.12 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $134.90 Median $134.90 Typical High $213.80 | Professional | 50 · Both sides | $134.90 | $134.90 | $213.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $44.67 Median $44.67 Typical High $70.79 | Professional | 51 · Multiple procedures | $44.67 | $44.67 | $70.79 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.20 Median $18.20 Typical High $28.18 | Professional | 80 · Assistant surgeon | $18.20 | $18.20 | $28.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.59 Median $12.59 Typical High $19.95 | Professional | 81 · Minimal assistant surgeon | $12.59 | $12.59 | $19.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.59 Median $12.59 Typical High $19.95 | Professional | 82 · Assistant surgeon, no resident | $12.59 | $12.59 | $19.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.59 Median $12.59 Typical High $19.95 | Professional | AS · PA/NP assist | $12.59 | $12.59 | $19.95 |
Where South Carolina sits
The same service costs 5.9 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· 18th of 51
$79.43
IA $117KY $19.95
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.