How much rates vary
Facilitymedian $417 · 10th to 90th $141 to $3,715Professionalmedian $282 · 10th to 90th $120 to $457
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 $223.87 Median $354.81 Typical High $21,877.62 | Facility | None | $223.87 | $354.81 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $354.81 | Professional | None | $223.87 | $323.59 | $354.81 |
BCBS South Carolina Setting Facility Modifier None Typical Low $239.88 Median $416.87 Typical High $707.95 | Facility | None | $239.88 | $416.87 | $707.95 |
BCBS South Carolina Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $309.03 | Professional | None | $120.23 | $181.97 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $794.33 | Facility | None | $52.48 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $524.81 | Professional | None | $229.09 | $354.81 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $165.96 Typical High $478.63 | Facility | None | $66.07 | $165.96 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $380.19 Typical High $489.78 | Professional | None | $181.97 | $380.19 | $489.78 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $269.15 Typical High $426.58 | Professional | None | $33.88 | $269.15 | $426.58 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,025.60 | Facility | None | $302.00 | $1,122.02 | $6,025.60 |
United Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $562.34 | Professional | None | $204.17 | $323.59 | $562.34 |
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 $112.20 Median $125.89 Typical High $177.83 | Professional | 52 · Reduced service | $112.20 | $125.89 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $50.12 Typical High $70.79 | Professional | 53 · Discontinued | $44.67 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $190.55 Typical High $269.15 | Professional | 54 · Surgery only | $169.82 | $190.55 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.02 Typical High $53.70 | Professional | 55 · Aftercare only | $33.88 | $38.02 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.12 Typical High $35.48 | Professional | 56 · Pre-op care only | $22.39 | $25.12 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $177.83 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $158.49 | $177.83 | $251.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $91.20 Median $218.78 Typical High $245.47 | Professional | 51 · Multiple procedures | $91.20 | $218.78 | $245.47 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $36.31 Median $87.10 Typical High $97.72 | Professional | 80 · Assistant surgeon | $36.31 | $87.10 | $97.72 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $25.70 Median $61.66 Typical High $67.61 | Professional | 81 · Minimal assistant surgeon | $25.70 | $61.66 | $67.61 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $25.70 Median $61.66 Typical High $67.61 | Professional | 82 · Assistant surgeon, no resident | $25.70 | $61.66 | $67.61 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $25.70 Median $61.66 Typical High $67.61 | Professional | AS · PA/NP assist | $25.70 | $61.66 | $67.61 |
Where South Carolina sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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
$309
AK $933KY $229
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.