How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,514 to $16,218Professionalmedian $646 · 10th to 90th $427 to $912
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 $562.34 Median $10,000.00 Typical High $21,877.62 | Facility | None | $562.34 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $562.34 | Professional | None | $467.74 | $562.34 | $562.34 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $5,128.61 Typical High $14,125.38 | Facility | None | $1,905.46 | $5,128.61 | $14,125.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $933.25 | Professional | None | $426.58 | $676.08 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,623.41 Typical High $7,762.47 | Facility | None | $602.56 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $1,023.29 | Professional | None | $537.03 | $575.44 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $562.34 Typical High $5,128.61 | Facility | None | $457.09 | $562.34 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $776.25 | Professional | None | $537.03 | $691.83 | $776.25 |
Molina Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $933.25 | Professional | None | $457.09 | $660.69 | $933.25 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $977.24 | Professional | None | $446.68 | $575.44 | $977.24 |
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 $234.42 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $234.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $93.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $346.74 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $69.18 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $46.77 | $56.23 | $56.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $309.03 Median $371.54 Typical High $426.58 | Professional | 51 · Multiple procedures | $309.03 | $371.54 | $426.58 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $147.91 Typical High $169.82 | Professional | 80 · Assistant surgeon | $123.03 | $147.91 | $169.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $87.10 Median $102.33 Typical High $117.49 | Professional | 81 · Minimal assistant surgeon | $87.10 | $102.33 | $117.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $87.10 Median $102.33 Typical High $117.49 | Professional | 82 · Assistant surgeon, no resident | $87.10 | $102.33 | $117.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $102.33 Typical High $117.49 | Professional | AS · PA/NP assist | $87.10 | $102.33 | $117.49 |
Where South Carolina sits
The same service costs 3.9 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· 28th of 51
$741
AK $1,905NY $490
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.