How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,000 to $10,715Professionalmedian $174 · 10th to 90th $120 to $257
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 $151.36 Median $10,964.78 Typical High $21,877.62 | Facility | None | $151.36 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $151.36 | Professional | None | $128.82 | $151.36 | $151.36 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $2,630.27 Typical High $8,128.31 | Facility | None | $1,202.26 | $2,630.27 | $8,128.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $263.03 | Professional | None | $114.82 | $199.53 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,905.46 Typical High $3,162.28 | Facility | None | $630.96 | $1,905.46 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $234.42 | Professional | None | $134.90 | $158.49 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $891.25 Typical High $2,089.30 | Facility | None | $144.54 | $891.25 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $199.53 | Professional | None | $151.36 | $173.78 | $199.53 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $275.42 | Professional | None | $125.89 | $190.55 | $275.42 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $269.15 | Professional | None | $125.89 | $165.96 | $269.15 |
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 $64.57 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $64.57 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $25.70 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $112.20 Typical High $112.20 | Professional | 54 · Surgery only | $95.50 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $19.05 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.88 | $15.14 | $15.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $81.28 Median $93.33 Typical High $120.23 | Professional | 51 · Multiple procedures | $81.28 | $93.33 | $120.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $32.36 Median $38.02 Typical High $46.77 | Professional | 80 · Assistant surgeon | $32.36 | $38.02 | $46.77 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $22.91 Median $26.30 Typical High $33.11 | Professional | 81 · Minimal assistant surgeon | $22.91 | $26.30 | $33.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $22.91 Median $26.30 Typical High $33.11 | Professional | 82 · Assistant surgeon, no resident | $22.91 | $26.30 | $33.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $22.91 Median $26.30 Typical High $33.11 | Professional | AS · PA/NP assist | $22.91 | $26.30 | $33.11 |
Where South Carolina sits
The same service costs 10.7 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· 30th of 51
$200
OK $1,413NY $132
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.