How much rates vary
Facilitymedian $2,630 · 10th to 90th $794 to $15,488Professionalmedian $447 · 10th to 90th $282 to $617
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 $346.74 Median $10,000.00 Typical High $21,877.62 | Facility | None | $346.74 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $407.38 | Professional | None | $309.03 | $346.74 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $4,365.16 Typical High $15,135.61 | Facility | None | $851.14 | $4,365.16 | $15,135.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $263.03 Median $501.19 Typical High $741.31 | Professional | None | $263.03 | $501.19 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,454.71 Typical High $3,548.13 | Facility | None | $602.56 | $2,454.71 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $630.96 | Professional | None | $346.74 | $426.58 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $741.31 Typical High $2,951.21 | Facility | None | $371.54 | $741.31 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $588.84 | Professional | None | $363.08 | $489.78 | $588.84 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $588.84 | Professional | None | $295.12 | $426.58 | $588.84 |
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 $309.03 Median $416.87 Typical High $691.83 | Professional | None | $309.03 | $416.87 | $691.83 |
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 $154.88 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $154.88 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $61.66 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $229.09 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $45.71 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $30.90 | $34.67 | $34.67 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $204.17 Median $251.19 Typical High $295.12 | Professional | 51 · Multiple procedures | $204.17 | $251.19 | $295.12 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $97.72 Typical High $117.49 | Professional | 80 · Assistant surgeon | $83.18 | $97.72 | $117.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $57.54 Median $67.61 Typical High $83.18 | Professional | 81 · Minimal assistant surgeon | $57.54 | $67.61 | $83.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $57.54 Median $67.61 Typical High $83.18 | Professional | 82 · Assistant surgeon, no resident | $57.54 | $67.61 | $83.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $67.61 Typical High $83.18 | Professional | AS · PA/NP assist | $57.54 | $67.61 | $83.18 |
Where South Carolina sits
The same service costs 10.0 times more in Oklahoma 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· 27th of 51
$537
OK $2,884NY $288
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.