How much rates vary
Facilitymedian $631 · 10th to 90th $87 to $1,995Professionalmedian $93 · 10th to 90th $32 to $170
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 $33.88 Median $4,897.79 Typical High $21,877.62 | Facility | None | $33.88 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $91.20 Typical High $114.82 | Professional | None | $32.36 | $91.20 | $114.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $501.19 Median $870.96 Typical High $1,584.89 | Facility | None | $501.19 | $870.96 | $1,584.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $26.92 Median $34.67 Typical High $93.33 | Professional | None | $26.92 | $34.67 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $104.71 Typical High $223.87 | Facility | None | $75.86 | $104.71 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $93.33 Typical High $186.21 | Professional | None | $34.67 | $93.33 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $37.15 Median $125.89 Typical High $724.44 | Facility | None | $37.15 | $125.89 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $151.36 | Professional | None | $85.11 | $120.23 | $151.36 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $190.55 | Professional | None | $93.33 | $138.04 | $190.55 |
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 $28.84 Median $77.62 Typical High $162.18 | Professional | None | $28.84 | $77.62 | $162.18 |
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 $16.98 Median $19.50 Typical High $57.54 | Professional | 52 · Reduced service | $16.98 | $19.50 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $7.94 Typical High $22.91 | Professional | 53 · Discontinued | $6.76 | $7.94 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $29.51 Typical High $87.10 | Professional | 54 · Surgery only | $25.12 | $29.51 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.89 Typical High $17.38 | Professional | 55 · Aftercare only | $5.01 | $5.89 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.98 Typical High $11.48 | Professional | 56 · Pre-op care only | $3.39 | $3.98 | $11.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $42.66 Median $60.26 Typical High $87.10 | Professional | 51 · Multiple procedures | $42.66 | $60.26 | $87.10 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.98 Median $23.99 Typical High $34.67 | Professional | 80 · Assistant surgeon | $16.98 | $23.99 | $34.67 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.02 Median $16.60 Typical High $23.99 | Professional | 81 · Minimal assistant surgeon | $12.02 | $16.60 | $23.99 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.02 Median $16.60 Typical High $23.99 | Professional | 82 · Assistant surgeon, no resident | $12.02 | $16.60 | $23.99 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.02 Median $16.60 Typical High $23.99 | Professional | AS · PA/NP assist | $12.02 | $16.60 | $23.99 |
Where South Carolina sits
The same service costs 5.4 times more in Wisconsin 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· 29th of 51
$100
WI $209HI $38.90
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.