How much rates vary
Facilitymedian $4,169 · 10th to 90th $708 to $15,849Professionalmedian $263 · 10th to 90th $182 to $708
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 $707.95 Median $5,623.41 Typical High $21,877.62 | Facility | None | $707.95 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $707.95 | Professional | None | $588.84 | $707.95 | $707.95 |
BCBS South Carolina Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $281.84 | Professional | None | $181.97 | $199.53 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,511.89 Typical High $6,760.83 | Facility | None | $549.54 | $2,511.89 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,071.52 | Professional | None | $645.65 | $645.65 | $1,071.52 |
Medcost Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $954.99 | Facility | None | $501.19 | $707.95 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $691.83 Typical High $794.33 | Professional | None | $229.09 | $691.83 | $794.33 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $6,760.83 Typical High $16,982.44 | Facility | None | $1,023.29 | $6,760.83 | $16,982.44 |
United Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $562.34 | Professional | None | $223.87 | $302.00 | $562.34 |
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 $295.12 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $295.12 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $117.49 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $436.52 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $89.13 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $58.88 | $70.79 | $70.79 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $1,071.52 Typical High $1,584.89 | Professional | 50 · Both sides | $346.74 | $1,071.52 | $1,584.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $114.82 Median $354.81 Typical High $537.03 | Professional | 51 · Multiple procedures | $114.82 | $354.81 | $537.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $45.71 Median $141.25 Typical High $213.80 | Professional | 80 · Assistant surgeon | $45.71 | $141.25 | $213.80 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $32.36 Median $100.00 Typical High $147.91 | Professional | 81 · Minimal assistant surgeon | $32.36 | $100.00 | $147.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $32.36 Median $100.00 Typical High $147.91 | Professional | 82 · Assistant surgeon, no resident | $32.36 | $100.00 | $147.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $32.36 Median $100.00 Typical High $147.91 | Professional | AS · PA/NP assist | $32.36 | $100.00 | $147.91 |
Where South Carolina sits
The same service costs 10.0 times more in Alaska than in Kentucky. 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· 49th of 51
$324
AK $2,455KY $245
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.