How much rates vary
Facilitymedian $513 · 10th to 90th $100 to $6,918Professionalmedian $110 · 10th to 90th $89 to $178
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $89.13 Median $112.20 Typical High $295.12 | Facility | None | $89.13 | $112.20 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $151.36 | Professional | None | $89.13 | $100.00 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $177.83 | Professional | None | $91.20 | $107.15 | $177.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $1,047.13 | Facility | None | $512.86 | $512.86 | $1,047.13 |
BCBS South Carolina Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $107.15 | Professional | None | $89.13 | $93.33 | $107.15 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $87.10 Median $120.23 Typical High $131.83 | Professional | 29 | $87.10 | $120.23 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $4,265.80 Median $6,165.95 Typical High $8,128.31 | Facility | None | $4,265.80 | $6,165.95 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $158.49 | Professional | None | $97.72 | $109.65 | $158.49 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $223.87 | Professional | None | $138.04 | $138.04 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $97.72 Median $109.65 Typical High $295.12 | Facility | None | $97.72 | $109.65 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $162.18 | Professional | None | $123.03 | $134.90 | $162.18 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $245.47 | Professional | None | $125.89 | $158.49 | $245.47 |
United Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $162.18 | Professional | None | $93.33 | $114.82 | $162.18 |
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 $44.67 Median $50.12 Typical High $53.70 | Professional | 52 · Reduced service | $44.67 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.14 Typical High $15.85 | Professional | 55 · Aftercare only | $13.49 | $15.14 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.00 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.91 | $10.00 | $10.72 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $91.20 Median $144.54 Typical High $177.83 | Professional | 25 · Same-day visit | $91.20 | $144.54 | $177.83 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | GC · Resident with teaching physician | $138.04 | $138.04 | $138.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $61.66 Median $67.61 Typical High $87.10 | Professional | 51 · Multiple procedures | $61.66 | $67.61 | $87.10 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $24.55 Median $26.92 Typical High $34.67 | Professional | 80 · Assistant surgeon | $24.55 | $26.92 | $34.67 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.38 Median $18.62 Typical High $23.99 | Professional | 81 · Minimal assistant surgeon | $17.38 | $18.62 | $23.99 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.38 Median $18.62 Typical High $23.99 | Professional | 82 · Assistant surgeon, no resident | $17.38 | $18.62 | $23.99 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.38 Median $18.62 Typical High $23.99 | Professional | AS · PA/NP assist | $17.38 | $18.62 | $23.99 |
Where South Carolina sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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· 43rd of 51
$110
AK $263NJ $97.72
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.