How much rates vary
Facilitymedian $1,072 · 10th to 90th $603 to $4,677Professionalmedian $331 · 10th to 90th $240 to $513
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 $331.13 Median $5,888.44 Typical High $21,877.62 | Facility | None | $331.13 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $331.13 | Professional | None | $275.42 | $331.13 | $331.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $1,202.26 Typical High $3,981.07 | Facility | None | $676.08 | $1,202.26 | $3,981.07 |
BCBS South Carolina Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $512.86 | Professional | None | $239.88 | $389.05 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $1,621.81 | Facility | None | $602.56 | $1,000.00 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $331.13 Typical High $489.78 | Professional | None | $323.59 | $331.13 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $645.65 | Professional | None | $398.11 | $426.58 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $588.84 Typical High $1,122.02 | Facility | None | $331.13 | $588.84 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $562.34 | Professional | None | $323.59 | $389.05 | $562.34 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $501.19 | Professional | None | $251.19 | $323.59 | $501.19 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $549.54 | Professional | None | $239.88 | $295.12 | $549.54 |
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 $138.04 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $138.04 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $54.95 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $208.93 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $41.69 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $27.54 | $33.11 | $33.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $186.21 Median $194.98 Typical High $281.84 | Professional | 51 · Multiple procedures | $186.21 | $194.98 | $281.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $79.43 Typical High $112.20 | Professional | 80 · Assistant surgeon | $74.13 | $79.43 | $112.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $51.29 Median $54.95 Typical High $79.43 | Professional | 81 · Minimal assistant surgeon | $51.29 | $54.95 | $79.43 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $51.29 Median $54.95 Typical High $79.43 | Professional | 82 · Assistant surgeon, no resident | $51.29 | $54.95 | $79.43 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $54.95 Typical High $79.43 | Professional | AS · PA/NP assist | $51.29 | $54.95 | $79.43 |
Where South Carolina sits
The same service costs 5.2 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $4,508MT $873
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.