How much rates vary
Facilitymedian $525 · 10th to 90th $151 to $1,622Professionalmedian $380 · 10th to 90th $107 to $550
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 $489.78 Typical High $21,877.62 | Facility | None | $380.19 | $489.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $489.78 | Professional | None | $380.19 | $436.52 | $489.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $426.58 Median $741.31 Typical High $1,288.25 | Facility | None | $426.58 | $741.31 | $1,288.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $416.87 | Professional | None | $295.12 | $316.23 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $407.38 Typical High $707.95 | Facility | None | $251.19 | $407.38 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $616.60 | Professional | None | $323.59 | $426.58 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $147.91 Median $302.00 Typical High $549.54 | Facility | None | $147.91 | $302.00 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $575.44 | Professional | None | $371.54 | $489.78 | $575.44 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $316.23 Typical High $512.86 | Professional | None | $38.02 | $316.23 | $512.86 |
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 $309.03 Median $407.38 Typical High $758.58 | Professional | None | $309.03 | $407.38 | $758.58 |
11 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 $190.55 Median $190.55 Typical High $239.88 | Professional | 52 · Reduced service | $190.55 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $97.72 | Professional | 53 · Discontinued | $75.86 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $363.08 | Professional | 54 · Surgery only | $288.40 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $72.44 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $48.98 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $338.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $186.21 Median $245.47 Typical High $316.23 | Professional | 51 · Multiple procedures | $186.21 | $245.47 | $316.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $97.72 Typical High $128.82 | Professional | 80 · Assistant surgeon | $75.86 | $97.72 | $128.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $52.48 Median $69.18 Typical High $89.13 | Professional | 81 · Minimal assistant surgeon | $52.48 | $69.18 | $89.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $52.48 Median $69.18 Typical High $89.13 | Professional | 82 · Assistant surgeon, no resident | $52.48 | $69.18 | $89.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $52.48 Median $69.18 Typical High $89.13 | Professional | AS · PA/NP assist | $52.48 | $69.18 | $89.13 |
Where South Carolina sits
The same service costs 6.0 times more in Alaska than in Texas. 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· 41st of 51
$398
AK $1,445TX $240
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.