How much rates vary
Facilitymedian $575 · 10th to 90th $69 to $1,660Professionalmedian $100 · 10th to 90th $62 to $174
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 $63.10 Median $100.00 Typical High $21,877.62 | Facility | None | $63.10 | $100.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $100.00 | Professional | None | $58.88 | $75.86 | $100.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $467.74 Median $794.33 Typical High $1,513.56 | Facility | None | $467.74 | $794.33 | $1,513.56 |
BCBS South Carolina Setting Professional Modifier None Typical Low $47.86 Median $97.72 Typical High $123.03 | Professional | None | $47.86 | $97.72 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $125.89 Typical High $707.95 | Facility | None | $57.54 | $125.89 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $158.49 | Professional | None | $64.57 | $97.72 | $158.49 |
Medcost Setting Facility Modifier None Typical Low $56.23 Median $75.86 Typical High $109.65 | Facility | None | $56.23 | $75.86 | $109.65 |
Medcost Setting Professional Modifier None Typical Low $87.10 Median $112.20 Typical High $128.82 | Professional | None | $87.10 | $112.20 | $128.82 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $190.55 | Professional | None | $95.50 | $138.04 | $190.55 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $151.36 | Professional | None | $57.54 | $89.13 | $151.36 |
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 $30.90 Median $34.67 Typical High $50.12 | Professional | 52 · Reduced service | $30.90 | $34.67 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $14.13 Typical High $19.95 | Professional | 53 · Discontinued | $12.59 | $14.13 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $52.48 Typical High $75.86 | Professional | 54 · Surgery only | $46.77 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.47 Typical High $15.14 | Professional | 55 · Aftercare only | $9.33 | $10.47 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.08 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.17 | $7.08 | $10.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $53.70 Median $63.10 Typical High $81.28 | Professional | 51 · Multiple procedures | $53.70 | $63.10 | $81.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $21.38 Median $25.12 Typical High $32.36 | Professional | 80 · Assistant surgeon | $21.38 | $25.12 | $32.36 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.14 Median $17.78 Typical High $22.91 | Professional | 81 · Minimal assistant surgeon | $15.14 | $17.78 | $22.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.14 Median $17.78 Typical High $22.91 | Professional | 82 · Assistant surgeon, no resident | $15.14 | $17.78 | $22.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.14 Median $17.78 Typical High $22.91 | Professional | AS · PA/NP assist | $15.14 | $17.78 | $22.91 |
Where South Carolina sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 18th of 51
$112
WI $240DC $77.62
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.