How much rates vary
Facilitymedian $794 · 10th to 90th $151 to $6,761Professionalmedian $759 · 10th to 90th $132 to $1,047
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 $562.34 Median $776.25 Typical High $21,877.62 | Facility | None | $562.34 | $776.25 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $776.25 | Professional | None | $562.34 | $660.69 | $776.25 |
Ambetter Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
BCBS South Carolina Setting Facility Modifier None Typical Low $501.19 Median $912.01 Typical High $7,079.46 | Facility | None | $501.19 | $912.01 | $7,079.46 |
BCBS South Carolina Setting Professional Modifier None Typical Low $416.87 Median $812.83 Typical High $1,047.13 | Professional | None | $416.87 | $812.83 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $323.59 Typical High $1,318.26 | Facility | None | $144.54 | $323.59 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,148.15 | Professional | None | $676.08 | $794.33 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $478.63 Typical High $912.01 | Facility | None | $309.03 | $478.63 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,023.29 | Professional | None | $776.25 | $891.25 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $691.83 Typical High $1,071.52 | Professional | None | $77.62 | $691.83 | $1,071.52 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $1,122.02 | Professional | None | $446.68 | $676.08 | $1,122.02 |
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 $281.84 Median $302.00 Typical High $389.05 | Professional | 52 · Reduced service | $281.84 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $123.03 Typical High $154.88 | Professional | 53 · Discontinued | $112.20 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $457.09 Typical High $575.44 | Professional | 54 · Surgery only | $416.87 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $91.20 Typical High $114.82 | Professional | 55 · Aftercare only | $83.18 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $60.26 Typical High $77.62 | Professional | 56 · Pre-op care only | $56.23 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $426.58 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $389.05 | $426.58 | $537.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $426.58 Median $478.63 Typical High $602.56 | Professional | 51 · Multiple procedures | $426.58 | $478.63 | $602.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $194.98 Typical High $239.88 | Professional | 80 · Assistant surgeon | $173.78 | $194.98 | $239.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $120.23 Median $134.90 Typical High $165.96 | Professional | 81 · Minimal assistant surgeon | $120.23 | $134.90 | $165.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $120.23 Median $134.90 Typical High $165.96 | Professional | 82 · Assistant surgeon, no resident | $120.23 | $134.90 | $165.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $134.90 Typical High $165.96 | Professional | AS · PA/NP assist | $120.23 | $134.90 | $165.96 |
Where South Carolina sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 28th of 51
$759
AK $1,950MD $537
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.