How much rates vary
Facilitymedian $676 · 10th to 90th $200 to $1,202Professionalmedian $263 · 10th to 90th $145 to $457
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 $162.18 Median $5,623.41 Typical High $21,877.62 | Facility | None | $162.18 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $331.13 | Professional | None | $158.49 | $229.09 | $331.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $338.84 Median $707.95 Typical High $933.25 | Facility | None | $338.84 | $707.95 | $933.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $112.20 Median $245.47 Typical High $309.03 | Professional | None | $112.20 | $245.47 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $537.03 Typical High $977.24 | Facility | None | $239.88 | $537.03 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $269.15 Typical High $426.58 | Professional | None | $151.36 | $269.15 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $134.90 Median $371.54 Typical High $851.14 | Facility | None | $134.90 | $371.54 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $380.19 | Professional | None | $257.04 | $316.23 | $380.19 |
Molina Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $512.86 | Professional | None | $257.04 | $363.08 | $512.86 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $436.52 | Professional | None | $128.82 | $245.47 | $436.52 |
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 $81.28 Median $83.18 Typical High $162.18 | Professional | 52 · Reduced service | $81.28 | $83.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $33.11 Typical High $66.07 | Professional | 53 · Discontinued | $32.36 | $33.11 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $123.03 Typical High $245.47 | Professional | 54 · Surgery only | $120.23 | $123.03 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $48.98 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.60 Typical High $33.11 | Professional | 56 · Pre-op care only | $16.22 | $16.60 | $33.11 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $501.19 Typical High $724.44 | Professional | 50 · Both sides | $416.87 | $501.19 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $138.04 Median $165.96 Typical High $239.88 | Professional | 51 · Multiple procedures | $138.04 | $165.96 | $239.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $66.07 Typical High $97.72 | Professional | 80 · Assistant surgeon | $54.95 | $66.07 | $97.72 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $38.90 Median $46.77 Typical High $67.61 | Professional | 81 · Minimal assistant surgeon | $38.90 | $46.77 | $67.61 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $38.90 Median $46.77 Typical High $67.61 | Professional | 82 · Assistant surgeon, no resident | $38.90 | $46.77 | $67.61 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $38.90 Median $46.77 Typical High $67.61 | Professional | AS · PA/NP assist | $38.90 | $46.77 | $67.61 |
Where South Carolina sits
The same service costs 3.2 times more in Wisconsin 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· 22nd of 51
$288
WI $646KY $204
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.