How much rates vary
Facilitymedian $794 · 10th to 90th $126 to $2,042Professionalmedian $120 · 10th to 90th $81 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 $134.90 Median $5,623.41 Typical High $21,877.62 | Facility | None | $134.90 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $134.90 | Professional | None | $100.00 | $134.90 | $134.90 |
BCBS South Carolina Setting Facility Modifier None Typical Low $537.03 Median $912.01 Typical High $1,548.82 | Facility | None | $537.03 | $912.01 | $1,548.82 |
BCBS South Carolina Setting Professional Modifier None Typical Low $81.28 Median $93.33 Typical High $123.03 | Professional | None | $81.28 | $93.33 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $1,122.02 | Facility | None | $489.78 | $602.56 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $181.97 | Professional | None | $123.03 | $134.90 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $102.33 Median $134.90 Typical High $269.15 | Facility | None | $102.33 | $134.90 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $147.91 | Professional | None | $112.20 | $147.91 | $147.91 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $85.11 Typical High $131.83 | Professional | None | $66.07 | $85.11 | $131.83 |
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 $87.10 Median $107.15 Typical High $204.17 | Professional | None | $87.10 | $107.15 | $204.17 |
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 $48.98 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $48.98 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $19.50 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $102.33 Typical High $102.33 | Professional | 54 · Surgery only | $74.13 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $14.79 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.77 | $13.49 | $13.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $70.79 Median $74.13 Typical High $74.13 | Professional | 51 · Multiple procedures | $70.79 | $74.13 | $74.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.18 Median $29.51 Typical High $29.51 | Professional | 80 · Assistant surgeon | $28.18 | $29.51 | $29.51 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.50 Median $20.42 Typical High $20.89 | Professional | 81 · Minimal assistant surgeon | $19.50 | $20.42 | $20.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.50 Median $20.42 Typical High $20.89 | Professional | 82 · Assistant surgeon, no resident | $19.50 | $20.42 | $20.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.50 Median $20.42 Typical High $20.89 | Professional | AS · PA/NP assist | $19.50 | $20.42 | $20.89 |
Where South Carolina sits
The same service costs 4.0 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· 32nd of 51
$123
AK $372FL $93.33
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.