How much rates vary
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 $239.88 Median $9,120.11 Typical High $22,908.68 | Facility | None | $239.88 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $239.88 | Professional | None | $194.98 | $239.88 | $239.88 |
BCBS South Carolina Setting Professional Modifier None Typical Low $194.98 Median $446.68 Typical High $616.60 | Professional | None | $194.98 | $446.68 | $616.60 |
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 $208.93 Median $309.03 Typical High $524.81 | Professional | None | $208.93 | $309.03 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $263.03 Typical High $323.59 | Facility | None | $239.88 | $263.03 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $269.15 | Professional | None | $223.87 | $239.88 | $269.15 |
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 $154.88 Median $223.87 Typical High $371.54 | Professional | None | $154.88 | $223.87 | $371.54 |
8 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 54 · Surgery only Typical Low $144.54 Median $177.83 Typical High $177.83 | Professional | 54 · Surgery only | $144.54 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $28.84 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $19.50 | $23.99 | $23.99 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $117.49 Median $120.23 Typical High $173.78 | Professional | 51 · Multiple procedures | $117.49 | $120.23 | $173.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $46.77 Median $48.98 Typical High $69.18 | Professional | 80 · Assistant surgeon | $46.77 | $48.98 | $69.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.11 Median $33.88 Typical High $48.98 | Professional | 81 · Minimal assistant surgeon | $33.11 | $33.88 | $48.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.11 Median $33.88 Typical High $48.98 | Professional | 82 · Assistant surgeon, no resident | $33.11 | $33.88 | $48.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $33.88 Typical High $48.98 | Professional | AS · PA/NP assist | $33.11 | $33.88 | $48.98 |
Where South Carolina sits
The same service costs 10.5 times more in North Dakota than in Kentucky. 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· 19th of 51
$355
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.