How much rates vary
Facilitymedian $1,288 · 10th to 90th $479 to $6,310Professionalmedian $89 · 10th to 90th $65 to $132
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 $95.50 Median $5,623.41 Typical High $21,877.62 | Facility | None | $95.50 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $95.50 | Professional | None | $72.44 | $95.50 | $95.50 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,348.96 Typical High $6,025.60 | Facility | None | $512.86 | $1,348.96 | $6,025.60 |
BCBS South Carolina Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $134.90 | Professional | None | $64.57 | $87.10 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,348.96 Typical High $1,905.46 | Facility | None | $457.09 | $1,348.96 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $91.20 Typical High $190.55 | Professional | None | $83.18 | $91.20 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $457.09 Typical High $1,096.48 | Facility | None | $70.79 | $457.09 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $177.83 | Professional | None | $85.11 | $100.00 | $177.83 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $125.89 | Professional | None | $64.57 | $89.13 | $125.89 |
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 $70.79 Median $87.10 Typical High $158.49 | Professional | None | $70.79 | $87.10 | $158.49 |
11 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 $36.31 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $36.31 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $14.45 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $72.44 Typical High $72.44 | Professional | 54 · Surgery only | $53.70 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $10.96 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.24 | $9.55 | $9.55 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $128.82 Median $151.36 Typical High $331.13 | Professional | 50 · Both sides | $128.82 | $151.36 | $331.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $42.66 Median $50.12 Typical High $109.65 | Professional | 51 · Multiple procedures | $42.66 | $50.12 | $109.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.98 Median $19.95 Typical High $35.48 | Professional | 80 · Assistant surgeon | $16.98 | $19.95 | $35.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.02 Median $14.13 Typical High $24.55 | Professional | 81 · Minimal assistant surgeon | $12.02 | $14.13 | $24.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.02 Median $14.13 Typical High $24.55 | Professional | 82 · Assistant surgeon, no resident | $12.02 | $14.13 | $24.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.02 Median $14.13 Typical High $24.55 | Professional | AS · PA/NP assist | $12.02 | $14.13 | $24.55 |
Where South Carolina sits
The same service costs 11.2 times more in Tennessee than in New York. 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· 35th of 51
$107
TN $832NY $74.13
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.