How much rates vary
Facilitymedian $1,778 · 10th to 90th $776 to $8,710Professionalmedian $871 · 10th to 90th $129 to $1,175
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 $1,000.00 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,000.00 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,000.00 | Professional | None | $891.25 | $1,000.00 | $1,000.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $1,949.84 Typical High $6,606.93 | Facility | None | $851.14 | $1,949.84 | $6,606.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,230.27 | Professional | None | $794.33 | $870.96 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,258.93 Typical High $2,041.74 | Facility | None | $602.56 | $1,258.93 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,258.93 | Professional | None | $724.44 | $891.25 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $794.33 Typical High $1,698.24 | Facility | None | $630.96 | $794.33 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,047.13 | Professional | None | $812.83 | $1,023.29 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $676.08 Typical High $1,071.52 | Professional | None | $79.43 | $676.08 | $1,071.52 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,548.82 | Professional | None | $691.83 | $870.96 | $1,548.82 |
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 $446.68 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $446.68 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $177.83 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $676.08 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $89.13 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $630.96 | $691.83 | $691.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $512.86 Typical High $660.69 | Professional | 51 · Multiple procedures | $407.38 | $512.86 | $660.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $204.17 Typical High $263.03 | Professional | 80 · Assistant surgeon | $162.18 | $204.17 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $141.25 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $114.82 | $141.25 | $181.97 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $141.25 Typical High $181.97 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $141.25 | $181.97 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $141.25 Typical High $181.97 | Professional | AS · PA/NP assist | $114.82 | $141.25 | $181.97 |
Where South Carolina sits
The same service costs 7.6 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· 42nd of 51
$912
AK $3,715TX $490
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.