How much rates vary
Facilitymedian $302 · 10th to 90th $115 to $1,585Professionalmedian $191 · 10th to 90th $52 to $263
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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $234.42 | Professional | None | $223.87 | $229.09 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $52.48 Median $128.82 Typical High $204.17 | Professional | None | $52.48 | $128.82 | $204.17 |
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 $186.21 Median $190.55 Typical High $288.40 | Professional | None | $186.21 | $190.55 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $229.09 Median $234.42 Typical High $602.56 | Facility | None | $229.09 | $234.42 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $257.04 | Professional | None | $213.80 | $213.80 | $257.04 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $331.13 | Professional | None | $181.97 | $229.09 | $331.13 |
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 $154.88 Median $199.53 Typical High $302.00 | Professional | None | $154.88 | $199.53 | $302.00 |
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 $112.20 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $112.20 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $44.67 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $33.88 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.39 | $22.91 | $22.91 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $107.15 Typical High $158.49 | Professional | 51 · Multiple procedures | $107.15 | $107.15 | $158.49 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $42.66 Typical High $64.57 | Professional | 80 · Assistant surgeon | $42.66 | $42.66 | $64.57 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $29.51 Median $29.51 Typical High $44.67 | Professional | 81 · Minimal assistant surgeon | $29.51 | $29.51 | $44.67 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $29.51 Median $29.51 Typical High $44.67 | Professional | 82 · Assistant surgeon, no resident | $29.51 | $29.51 | $44.67 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $29.51 Median $29.51 Typical High $44.67 | Professional | AS · PA/NP assist | $29.51 | $29.51 | $44.67 |
Where South Carolina sits
The same service costs 3.0 times more in Wisconsin 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· 49th of 51
$200
WI $537FL $182
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.