How much rates vary
Facilitymedian $245 · 10th to 90th $102 to $1,738Professionalmedian $380 · 10th to 90th $186 to $562
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 $186.21 Median $4,897.79 Typical High $21,877.62 | Facility | None | $186.21 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $389.05 | Professional | None | $186.21 | $234.42 | $389.05 |
BCBS South Carolina Setting Facility Modifier None Typical Low $102.33 Median $173.78 Typical High $309.03 | Facility | None | $102.33 | $173.78 | $309.03 |
BCBS South Carolina Setting Professional Modifier None Typical Low $154.88 Median $380.19 Typical High $467.74 | Professional | None | $154.88 | $380.19 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $602.56 Typical High $1,122.02 | Facility | None | $512.86 | $602.56 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $186.21 Median $389.05 Typical High $524.81 | Facility | None | $186.21 | $389.05 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $616.60 | Professional | None | $416.87 | $416.87 | $616.60 |
Molina Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $575.44 | Professional | None | $288.40 | $407.38 | $575.44 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $199.53 Median $416.87 Typical High $794.33 | Professional | None | $199.53 | $416.87 | $794.33 |
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 $91.20 Median $95.50 Typical High $194.98 | Professional | 52 · Reduced service | $91.20 | $95.50 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $38.02 Typical High $77.62 | Professional | 53 · Discontinued | $37.15 | $38.02 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $144.54 Typical High $288.40 | Professional | 54 · Surgery only | $138.04 | $144.54 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.84 Typical High $57.54 | Professional | 55 · Aftercare only | $27.54 | $28.84 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.05 Typical High $38.90 | Professional | 56 · Pre-op care only | $18.62 | $19.05 | $38.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $208.93 Median $208.93 Typical High $398.11 | Professional | 51 · Multiple procedures | $208.93 | $208.93 | $398.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $83.18 Typical High $158.49 | Professional | 80 · Assistant surgeon | $83.18 | $83.18 | $158.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $58.88 Median $58.88 Typical High $112.20 | Professional | 81 · Minimal assistant surgeon | $58.88 | $58.88 | $112.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $58.88 Median $58.88 Typical High $112.20 | Professional | 82 · Assistant surgeon, no resident | $58.88 | $58.88 | $112.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $58.88 Typical High $112.20 | Professional | AS · PA/NP assist | $58.88 | $58.88 | $112.20 |
Where South Carolina sits
The same service costs 2.8 times more in Wisconsin than in Utah. 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· 27th of 51
$363
WI $813UT $288
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.