How much rates vary
Facilitymedian $204 · 10th to 90th $79 to $1,122Professionalmedian $110 · 10th to 90th $74 to $158
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 $87.10 Median $87.10 Typical High $123.03 | Facility | None | $87.10 | $87.10 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $89.13 Typical High $123.03 | Professional | None | $87.10 | $89.13 | $123.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $169.82 Median $295.12 Typical High $512.86 | Facility | None | $169.82 | $295.12 | $512.86 |
BCBS South Carolina Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $138.04 | Professional | None | $64.57 | $93.33 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $83.18 Typical High $151.36 | Facility | None | $75.86 | $83.18 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $169.82 | Professional | None | $89.13 | $112.20 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $67.61 Median $91.20 Typical High $134.90 | Facility | None | $67.61 | $91.20 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $141.25 | Professional | None | $102.33 | $123.03 | $141.25 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $173.78 | Professional | None | $95.50 | $117.49 | $173.78 |
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 $67.61 Median $97.72 Typical High $162.18 | Professional | None | $67.61 | $97.72 | $162.18 |
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 $43.65 Median $44.67 Typical High $60.26 | Professional | 52 · Reduced service | $43.65 | $44.67 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.78 Typical High $24.55 | Professional | 53 · Discontinued | $17.38 | $17.78 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.49 Typical High $18.20 | Professional | 55 · Aftercare only | $13.18 | $13.49 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.12 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.71 | $9.12 | $12.30 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $154.88 Median $204.17 Typical High $281.84 | Professional | 50 · Both sides | $154.88 | $204.17 | $281.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $51.29 Median $67.61 Typical High $93.33 | Professional | 51 · Multiple procedures | $51.29 | $67.61 | $93.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $20.89 Median $26.92 Typical High $38.02 | Professional | 80 · Assistant surgeon | $20.89 | $26.92 | $38.02 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $14.45 Median $19.05 Typical High $26.30 | Professional | 81 · Minimal assistant surgeon | $14.45 | $19.05 | $26.30 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $14.45 Median $19.05 Typical High $26.30 | Professional | 82 · Assistant surgeon, no resident | $14.45 | $19.05 | $26.30 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $14.45 Median $19.05 Typical High $26.30 | Professional | AS · PA/NP assist | $14.45 | $19.05 | $26.30 |
Where South Carolina sits
The same service costs 3.8 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· 27th of 51
$112
AK $309FL $81.28
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.