How much rates vary
Facilitymedian $155 · 10th to 90th $87 to $269Professionalmedian $191 · 10th to 90th $100 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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | None | $173.78 | $190.55 | $190.55 |
BCBS South Carolina Setting Facility Modifier None Typical Low $85.11 Median $144.54 Typical High $251.19 | Facility | None | $85.11 | $144.54 | $251.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $208.93 | Professional | None | $100.00 | $151.36 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $2,238.72 | Facility | None | $1,023.29 | $1,023.29 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $229.09 Typical High $257.04 | Facility | None | $190.55 | $229.09 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $208.93 | Professional | None | $169.82 | $169.82 | $208.93 |
Molina Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $2,187.76 | Facility | None | $1,380.38 | $1,698.24 | $2,187.76 |
United Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $338.84 | Professional | None | $144.54 | $229.09 | $338.84 |
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 $87.10 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $87.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $34.67 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $26.30 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $17.38 | $19.05 | $19.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $85.11 Median $85.11 Typical High $131.83 | Professional | 51 · Multiple procedures | $85.11 | $85.11 | $131.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.88 Median $33.88 Typical High $52.48 | Professional | 80 · Assistant surgeon | $33.88 | $33.88 | $52.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $23.99 Median $23.99 Typical High $37.15 | Professional | 81 · Minimal assistant surgeon | $23.99 | $23.99 | $37.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $23.99 Median $23.99 Typical High $37.15 | Professional | 82 · Assistant surgeon, no resident | $23.99 | $23.99 | $37.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $23.99 Median $23.99 Typical High $37.15 | Professional | AS · PA/NP assist | $23.99 | $23.99 | $37.15 |
Where South Carolina sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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· 32nd of 51
$191
AK $501CT $158
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.