How much rates vary
Facilitymedian $933 · 10th to 90th $468 to $7,244Professionalmedian $302 · 10th to 90th $178 to $490
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 $199.53 Median $5,623.41 Typical High $21,877.62 | Facility | None | $199.53 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $331.13 | Professional | None | $194.98 | $245.47 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $281.84 | Professional | None | $151.36 | $158.49 | $281.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $954.99 Typical High $7,244.36 | Facility | None | $512.86 | $954.99 | $7,244.36 |
BCBS South Carolina Setting Professional Modifier None Typical Low $138.04 Median $251.19 Typical High $426.58 | Professional | None | $138.04 | $251.19 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $912.01 Typical High $1,412.54 | Facility | None | $457.09 | $912.01 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $457.09 | Professional | None | $218.78 | $323.59 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $1,047.13 | Facility | None | $199.53 | $436.52 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $489.78 | Professional | None | $288.40 | $407.38 | $489.78 |
Molina Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $501.19 | Professional | None | $257.04 | $363.08 | $501.19 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $512.86 | Professional | None | $162.18 | $275.42 | $512.86 |
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 $100.00 Median $102.33 Typical High $151.36 | Professional | 52 · Reduced service | $100.00 | $102.33 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $40.74 Typical High $60.26 | Professional | 53 · Discontinued | $39.81 | $40.74 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $154.88 Typical High $223.87 | Professional | 54 · Surgery only | $151.36 | $154.88 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.90 Typical High $44.67 | Professional | 55 · Aftercare only | $30.20 | $30.90 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $20.42 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.95 | $20.42 | $30.20 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $660.69 Typical High $741.31 | Professional | 50 · Both sides | $537.03 | $660.69 | $741.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $223.87 Typical High $245.47 | Professional | 51 · Multiple procedures | $177.83 | $223.87 | $245.47 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $89.13 Typical High $100.00 | Professional | 80 · Assistant surgeon | $70.79 | $89.13 | $100.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $50.12 Median $61.66 Typical High $69.18 | Professional | 81 · Minimal assistant surgeon | $50.12 | $61.66 | $69.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $50.12 Median $61.66 Typical High $69.18 | Professional | 82 · Assistant surgeon, no resident | $50.12 | $61.66 | $69.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $61.66 Typical High $69.18 | Professional | AS · PA/NP assist | $50.12 | $61.66 | $69.18 |
Where South Carolina sits
The same service costs 3.1 times more in Alaska than in New York. 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· 23rd of 51
$347
AK $794NY $257
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.