How much rates vary
Facilitymedian $257 · 10th to 90th $93 to $490Professionalmedian $74 · 10th to 90th $27 to $110
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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $74.13 Typical High $77.62 | Professional | None | $72.44 | $74.13 | $77.62 |
BCBS South Carolina Setting Facility Modifier None Typical Low $93.33 Median $281.84 Typical High $489.78 | Facility | None | $93.33 | $281.84 | $489.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $20.89 Median $41.69 Typical High $70.79 | Professional | None | $20.89 | $41.69 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $309.03 | Facility | None | $144.54 | $144.54 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $109.65 | Professional | None | $75.86 | $83.18 | $109.65 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $158.49 | Professional | None | $100.00 | $112.20 | $158.49 |
Medcost Setting Facility Modifier None Typical Low $72.44 Median $81.28 Typical High $190.55 | Facility | None | $72.44 | $81.28 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $25.70 Median $81.28 Typical High $125.89 | Professional | None | $25.70 | $81.28 | $125.89 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $120.23 | Professional | None | $60.26 | $77.62 | $120.23 |
United Setting Facility Modifier None Typical Low $194.98 Median $239.88 Typical High $309.03 | Facility | None | $194.98 | $239.88 | $309.03 |
United Setting Professional Modifier None Typical Low $61.66 Median $74.13 Typical High $109.65 | Professional | None | $61.66 | $74.13 | $109.65 |
9 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 $36.31 Median $37.15 Typical High $38.90 | Professional | 52 · Reduced service | $36.31 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.79 Typical High $15.85 | Professional | 53 · Discontinued | $14.45 | $14.79 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $11.75 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.41 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.24 | $7.41 | $7.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.88 Median $50.12 Typical High $63.10 | Professional | 51 · Multiple procedures | $12.88 | $50.12 | $63.10 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.25 Median $20.42 Typical High $25.12 | Professional | 80 · Assistant surgeon | $5.25 | $20.42 | $25.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.63 Median $14.13 Typical High $17.38 | Professional | 81 · Minimal assistant surgeon | $3.63 | $14.13 | $17.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.63 Median $14.13 Typical High $17.38 | Professional | 82 · Assistant surgeon, no resident | $3.63 | $14.13 | $17.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.63 Median $14.13 Typical High $17.38 | Professional | AS · PA/NP assist | $3.63 | $14.13 | $17.38 |
Where South Carolina sits
The same service costs 3.0 times more in Alaska than in Florida. 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· 47th of 51
$74.13
AK $195FL $64.57
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.