How much rates vary
Facilitymedian $1,175 · 10th to 90th $129 to $6,918Professionalmedian $158 · 10th to 90th $76 to $269
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 $95.50 Median $4,897.79 Typical High $21,877.62 | Facility | None | $95.50 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $165.96 Typical High $234.42 | Professional | None | $79.43 | $165.96 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
BCBS South Carolina Setting Professional Modifier None Typical Low $60.26 Median $125.89 Typical High $229.09 | Professional | None | $60.26 | $125.89 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $181.97 Typical High $295.12 | Professional | None | $91.20 | $181.97 | $295.12 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $177.83 Typical High $316.23 | Facility | None | $95.50 | $177.83 | $316.23 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $288.40 | Professional | None | $194.98 | $288.40 | $288.40 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $245.47 | Professional | None | $128.82 | $169.82 | $245.47 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $2,951.21 | Facility | None | $446.68 | $1,621.81 | $2,951.21 |
United Setting Professional Modifier None Typical Low $70.79 Median $169.82 Typical High $371.54 | Professional | None | $70.79 | $169.82 | $371.54 |
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 $47.86 Median $63.10 Typical High $117.49 | Professional | 52 · Reduced service | $47.86 | $63.10 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $25.12 Typical High $46.77 | Professional | 53 · Discontinued | $19.50 | $25.12 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $95.50 Typical High $173.78 | Professional | 54 · Surgery only | $72.44 | $95.50 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $19.05 Typical High $34.67 | Professional | 55 · Aftercare only | $14.45 | $19.05 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.59 Typical High $23.44 | Professional | 56 · Pre-op care only | $9.55 | $12.59 | $23.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $144.54 Typical High $181.97 | Professional | 51 · Multiple procedures | $120.23 | $144.54 | $181.97 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $57.54 Typical High $74.13 | Professional | 80 · Assistant surgeon | $47.86 | $57.54 | $74.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.88 Median $39.81 Typical High $51.29 | Professional | 81 · Minimal assistant surgeon | $33.88 | $39.81 | $51.29 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.88 Median $39.81 Typical High $51.29 | Professional | 82 · Assistant surgeon, no resident | $33.88 | $39.81 | $51.29 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $33.88 Median $39.81 Typical High $51.29 | Professional | AS · PA/NP assist | $33.88 | $39.81 | $51.29 |
Where South Carolina sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 40th of 51
$158
WI $316UT $117
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.