How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,514 to $18,197Professionalmedian $380 · 10th to 90th $331 to $575
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 $380.19 Median $9,120.11 Typical High $22,908.68 | Facility | None | $380.19 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | None | $363.08 | $380.19 | $380.19 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,467.37 Median $6,918.31 Typical High $14,454.40 | Facility | None | $3,467.37 | $6,918.31 | $14,454.40 |
BCBS South Carolina Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $407.38 | Professional | None | $346.74 | $346.74 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,981.07 Typical High $5,623.41 | Facility | None | $602.56 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $416.87 Typical High $4,677.35 | Facility | None | $380.19 | $416.87 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $501.19 | Professional | None | $389.05 | $389.05 | $501.19 |
Molina Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $645.65 | Professional | None | $363.08 | $446.68 | $645.65 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $575.44 | Professional | None | $309.03 | $389.05 | $575.44 |
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 $181.97 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $181.97 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $72.44 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $269.15 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $53.70 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $36.31 | $38.02 | $38.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $194.98 Typical High $331.13 | Professional | 51 · Multiple procedures | $194.98 | $194.98 | $331.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $77.62 Typical High $131.83 | Professional | 80 · Assistant surgeon | $77.62 | $77.62 | $131.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $53.70 Median $53.70 Typical High $93.33 | Professional | 81 · Minimal assistant surgeon | $53.70 | $53.70 | $93.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $53.70 Median $53.70 Typical High $93.33 | Professional | 82 · Assistant surgeon, no resident | $53.70 | $53.70 | $93.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $53.70 Typical High $93.33 | Professional | AS · PA/NP assist | $53.70 | $53.70 | $93.33 |
Where South Carolina sits
The same service costs 4.5 times more in Alaska than in New York. 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· 28th of 51
$437
AK $1,479NY $331
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.