How much rates vary
Facilitymedian $794 · 10th to 90th $309 to $8,318Professionalmedian $126 · 10th to 90th $91 to $166
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 $125.89 Median $9,120.11 Typical High $22,908.68 | Facility | None | $125.89 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $125.89 | Professional | None | $104.71 | $125.89 | $125.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $158.49 | Professional | None | $91.20 | $134.90 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $177.83 | Professional | None | $112.20 | $117.49 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $151.36 Typical High $245.47 | Professional | None | $141.25 | $151.36 | $245.47 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $724.44 Typical High $724.44 | Facility | None | $95.50 | $724.44 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $190.55 | Professional | None | $120.23 | $134.90 | $190.55 |
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 $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $190.55 | Professional | None | $91.20 | $109.65 | $190.55 |
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 $52.48 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $52.48 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $20.89 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $93.33 Typical High $93.33 | Professional | 54 · Surgery only | $79.43 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $15.85 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.47 | $12.59 | $12.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $64.57 Median $70.79 Typical High $97.72 | Professional | 51 · Multiple procedures | $64.57 | $70.79 | $97.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.70 Median $28.18 Typical High $38.90 | Professional | 80 · Assistant surgeon | $25.70 | $28.18 | $38.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.78 Median $19.50 Typical High $27.54 | Professional | 81 · Minimal assistant surgeon | $17.78 | $19.50 | $27.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.78 Median $19.50 Typical High $27.54 | Professional | 82 · Assistant surgeon, no resident | $17.78 | $19.50 | $27.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.78 Median $19.50 Typical High $27.54 | Professional | AS · PA/NP assist | $17.78 | $19.50 | $27.54 |
Where South Carolina sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 34th of 51
$126
AK $427NJ $97.72
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.