How much rates vary
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 $407.38 Median $9,120.11 Typical High $22,908.68 | Facility | None | $407.38 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $407.38 | Professional | None | $338.84 | $407.38 | $407.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $380.19 | Professional | None | $309.03 | $309.03 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $933.25 | Professional | None | $398.11 | $537.03 | $933.25 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $446.68 Typical High $549.54 | Facility | None | $407.38 | $446.68 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $457.09 | Professional | None | $331.13 | $446.68 | $457.09 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $707.95 | Professional | None | $295.12 | $398.11 | $707.95 |
8 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 54 · Surgery only Typical Low $251.19 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $251.19 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $50.12 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.88 | $40.74 | $40.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $199.53 Median $223.87 Typical High $302.00 | Professional | 51 · Multiple procedures | $199.53 | $223.87 | $302.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $89.13 Typical High $120.23 | Professional | 80 · Assistant surgeon | $81.28 | $89.13 | $120.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $56.23 Median $63.10 Typical High $85.11 | Professional | 81 · Minimal assistant surgeon | $56.23 | $63.10 | $85.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $56.23 Median $63.10 Typical High $85.11 | Professional | 82 · Assistant surgeon, no resident | $56.23 | $63.10 | $85.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $63.10 Typical High $85.11 | Professional | AS · PA/NP assist | $56.23 | $63.10 | $85.11 |
Where South Carolina sits
The same service costs 9.8 times more in Indiana than in Hawaii. 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· 46th of 51
$407
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.