How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,514 to $12,303Professionalmedian $468 · 10th to 90th $347 to $646
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 $478.63 Median $10,964.78 Typical High $21,877.62 | Facility | None | $478.63 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $478.63 | Professional | None | $398.11 | $478.63 | $478.63 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $4,073.80 Typical High $10,715.19 | Facility | None | $1,905.46 | $4,073.80 | $10,715.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $467.74 | Professional | None | $346.74 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,011.87 Typical High $7,079.46 | Facility | None | $602.56 | $5,011.87 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $691.83 | Professional | None | $467.74 | $467.74 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $933.25 | Professional | None | $562.34 | $602.56 | $933.25 |
Medcost Setting Facility Modifier None Typical Low $478.63 Median $1,698.24 Typical High $2,570.40 | Facility | None | $478.63 | $1,698.24 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $575.44 | Professional | None | $467.74 | $562.34 | $575.44 |
Molina Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $691.83 | Professional | None | $346.74 | $446.68 | $691.83 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $794.33 | Professional | None | $346.74 | $426.58 | $794.33 |
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 $199.53 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $199.53 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $79.43 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $302.00 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $60.26 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $39.81 | $47.86 | $47.86 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $275.42 Typical High $288.40 | Professional | 51 · Multiple procedures | $257.04 | $275.42 | $288.40 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $112.20 Typical High $114.82 | Professional | 80 · Assistant surgeon | $102.33 | $112.20 | $114.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $72.44 Median $77.62 Typical High $81.28 | Professional | 81 · Minimal assistant surgeon | $72.44 | $77.62 | $81.28 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $72.44 Median $77.62 Typical High $81.28 | Professional | 82 · Assistant surgeon, no resident | $72.44 | $77.62 | $81.28 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $77.62 Typical High $81.28 | Professional | AS · PA/NP assist | $72.44 | $77.62 | $81.28 |
Where South Carolina sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 36th of 51
$468
AK $1,622TX $363
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.