How much rates vary
Facilitymedian $309 · 10th to 90th $120 to $575Professionalmedian $38 · 10th to 90th $29 to $48
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 $38.02 Median $38.02 Typical High $46.77 | Facility | None | $38.02 | $38.02 | $46.77 |
Aetna Setting Professional Modifier None (both parts) Typical Low $38.02 Median $42.66 Typical High $46.77 | Professional | None (both parts) | $38.02 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $20.42 Typical High $22.91 | Professional | 52 · Reduced service | $19.05 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $8.13 Typical High $9.33 | Professional | 53 · Discontinued | $7.59 | $8.13 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.17 Typical High $6.92 | Professional | 55 · Aftercare only | $5.62 | $6.17 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.07 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.80 | $4.07 | $4.68 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $40.74 Median $40.74 Typical High $47.86 | Professional | None (both parts) | $40.74 | $40.74 | $47.86 |
BCBS South Carolina Setting Facility Modifier None Typical Low $194.98 Median $331.13 Typical High $575.44 | Facility | None | $194.98 | $331.13 | $575.44 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $28.84 Median $32.36 Typical High $45.71 | Professional | None (both parts) | $28.84 | $32.36 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $23.99 Median $38.02 Typical High $48.98 | Professional | None (both parts) | $23.99 | $38.02 | $48.98 |
Medcost Setting Facility Modifier None Typical Low $38.02 Median $47.86 Typical High $100.00 | Facility | None | $38.02 | $47.86 | $100.00 |
Medcost Setting Professional Modifier None (both parts) Typical Low $30.90 Median $34.67 Typical High $52.48 | Professional | None (both parts) | $30.90 | $34.67 | $52.48 |
Molina Setting Professional Modifier None (both parts) Typical Low $64.57 Median $83.18 Typical High $125.89 | Professional | None (both parts) | $64.57 | $83.18 | $125.89 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,445.44 | Facility | None | $912.01 | $1,096.48 | $1,445.44 |
United Setting Professional Modifier None (both parts) Typical Low $29.51 Median $38.02 Typical High $46.77 | Professional | None (both parts) | $29.51 | $38.02 | $46.77 |
7 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 26 · Professional part Typical Low $12.30 Median $15.14 Typical High $30.20 | Professional | 26 · Professional part | $12.30 | $15.14 | $30.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.49 Median $17.38 Typical High $32.36 | Professional | 51 · Multiple procedures | $15.49 | $17.38 | $32.36 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.17 Median $7.08 Typical High $12.88 | Professional | 80 · Assistant surgeon | $6.17 | $7.08 | $12.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.37 Median $4.90 Typical High $9.12 | Professional | 81 · Minimal assistant surgeon | $4.37 | $4.90 | $9.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.37 Median $4.90 Typical High $9.12 | Professional | 82 · Assistant surgeon, no resident | $4.37 | $4.90 | $9.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.37 Median $4.90 Typical High $9.12 | Professional | AS · PA/NP assist | $4.37 | $4.90 | $9.12 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $18.62 Median $25.12 Typical High $45.71 | Professional | TC · Technical part | $18.62 | $25.12 | $45.71 |
Where South Carolina sits
The same service costs 2.9 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· 45th of 51
$38.02
AK $100KY $34.67
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.