How much rates vary
Facilitymedian $302 · 10th to 90th $115 to $1,660Professionalmedian $112 · 10th to 90th $35 to $170
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 $138.04 Median $9,120.11 Typical High $22,908.68 | Facility | None | $138.04 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $165.96 | Professional | None | $89.13 | $138.04 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $131.83 | Professional | None | $112.20 | $112.20 | $131.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $177.83 Median $302.00 Typical High $1,096.48 | Facility | None | $177.83 | $302.00 | $1,096.48 |
BCBS South Carolina Setting Professional Modifier None Typical Low $30.90 Median $89.13 Typical High $120.23 | Professional | None | $30.90 | $89.13 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $190.55 | Professional | None | $112.20 | $123.03 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Medcost Setting Facility Modifier None Typical Low $33.88 Median $138.04 Typical High $363.08 | Facility | None | $33.88 | $138.04 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $40.74 Median $131.83 Typical High $154.88 | Professional | None | $40.74 | $131.83 | $154.88 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $223.87 | Professional | None | $120.23 | $151.36 | $223.87 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $194.98 | Professional | None | $97.72 | $123.03 | $194.98 |
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 $69.18 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | 54 · Surgery only | $102.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $13.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $20.42 Median $66.07 Typical High $97.72 | Professional | 51 · Multiple procedures | $20.42 | $66.07 | $97.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.13 Median $26.92 Typical High $38.90 | Professional | 80 · Assistant surgeon | $8.13 | $26.92 | $38.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.75 Median $18.62 Typical High $26.92 | Professional | 81 · Minimal assistant surgeon | $5.75 | $18.62 | $26.92 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.75 Median $18.62 Typical High $26.92 | Professional | 82 · Assistant surgeon, no resident | $5.75 | $18.62 | $26.92 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.75 Median $18.62 Typical High $26.92 | Professional | AS · PA/NP assist | $5.75 | $18.62 | $26.92 |
Where South Carolina sits
The same service costs 3.2 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
$123
AK $347KY $107
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.