How much rates vary
Facilitymedian $468 · 10th to 90th $93 to $1,318Professionalmedian $129 · 10th to 90th $81 to $191
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 $93.33 Median $93.33 Typical High $138.04 | Facility | None | $93.33 | $93.33 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $138.04 | Professional | None | $93.33 | $102.33 | $138.04 |
BCBS South Carolina Setting Facility Modifier None Typical Low $371.54 Median $660.69 Typical High $1,122.02 | Facility | None | $371.54 | $660.69 | $1,122.02 |
BCBS South Carolina Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $151.36 | Professional | None | $69.18 | $95.50 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $154.88 | Facility | None | $75.86 | $100.00 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $190.55 | Professional | None | $95.50 | $131.83 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $79.43 Median $123.03 Typical High $151.36 | Facility | None | $79.43 | $123.03 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $165.96 | Professional | None | $109.65 | $138.04 | $165.96 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $229.09 | Professional | None | $128.82 | $154.88 | $229.09 |
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 $72.44 Median $112.20 Typical High $190.55 | Professional | None | $72.44 | $112.20 | $190.55 |
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 $46.77 Median $51.29 Typical High $69.18 | Professional | 52 · Reduced service | $46.77 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $20.42 Typical High $27.54 | Professional | 53 · Discontinued | $18.62 | $20.42 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $15.49 Typical High $20.89 | Professional | 55 · Aftercare only | $14.13 | $15.49 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.23 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.33 | $10.23 | $13.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $245.47 Typical High $323.59 | Professional | 50 · Both sides | $162.18 | $245.47 | $323.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $54.95 Median $83.18 Typical High $107.15 | Professional | 51 · Multiple procedures | $54.95 | $83.18 | $107.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $21.88 Median $33.11 Typical High $42.66 | Professional | 80 · Assistant surgeon | $21.88 | $33.11 | $42.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.14 Median $22.91 Typical High $30.20 | Professional | 81 · Minimal assistant surgeon | $15.14 | $22.91 | $30.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.14 Median $22.91 Typical High $30.20 | Professional | 82 · Assistant surgeon, no resident | $15.14 | $22.91 | $30.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.14 Median $22.91 Typical High $30.20 | Professional | AS · PA/NP assist | $15.14 | $22.91 | $30.20 |
Where South Carolina sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 28th of 51
$132
AK $339MD $95.50
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.