How much rates vary
Facilitymedian $871 · 10th to 90th $347 to $8,511Professionalmedian $363 · 10th to 90th $234 to $537
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 $316.23 Median $9,120.11 Typical High $22,908.68 | Facility | None | $316.23 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $316.23 | Professional | None | $269.15 | $316.23 | $316.23 |
BCBS South Carolina Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $549.54 | Professional | None | $234.42 | $371.54 | $549.54 |
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 $281.84 Median $323.59 Typical High $501.19 | Professional | None | $281.84 | $323.59 | $501.19 |
Medcost Setting Facility Modifier None Typical Low $263.03 Median $316.23 Typical High $758.58 | Facility | None | $263.03 | $316.23 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $645.65 | Professional | None | $316.23 | $346.74 | $645.65 |
Molina Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $549.54 | Professional | None | $257.04 | $380.19 | $549.54 |
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 $263.03 Median $331.13 Typical High $562.34 | Professional | None | $263.03 | $331.13 | $562.34 |
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 $134.90 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $134.90 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $53.70 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $239.88 Typical High $239.88 | Professional | 54 · Surgery only | $204.17 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $40.74 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.92 | $31.62 | $31.62 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $169.82 Typical High $323.59 | Professional | 51 · Multiple procedures | $169.82 | $169.82 | $323.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $69.18 Typical High $128.82 | Professional | 80 · Assistant surgeon | $67.61 | $69.18 | $128.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $47.86 Median $47.86 Typical High $91.20 | Professional | 81 · Minimal assistant surgeon | $47.86 | $47.86 | $91.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $47.86 Median $47.86 Typical High $91.20 | Professional | 82 · Assistant surgeon, no resident | $47.86 | $47.86 | $91.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $47.86 Typical High $91.20 | Professional | AS · PA/NP assist | $47.86 | $47.86 | $91.20 |
Where South Carolina sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 32nd of 51
$372
AK $871TX $275
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.