How much rates vary
Facilitymedian $3,162 · 10th to 90th $676 to $17,783Professionalmedian $513 · 10th to 90th $107 to $977
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 $407.38 Median $5,623.41 Typical High $21,877.62 | Facility | None | $407.38 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $707.95 | Professional | None | $407.38 | $549.54 | $707.95 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $2,951.21 Typical High $17,378.01 | Facility | None | $691.83 | $2,951.21 | $17,378.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $1,000.00 | Professional | None | $269.15 | $407.38 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $4,677.35 | Facility | None | $602.56 | $1,995.26 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $741.31 Typical High $954.99 | Professional | None | $457.09 | $741.31 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $346.74 Median $691.83 Typical High $1,995.26 | Facility | None | $346.74 | $691.83 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $851.14 | Professional | None | $501.19 | $707.95 | $851.14 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $489.78 Typical High $851.14 | Professional | None | $38.90 | $489.78 | $851.14 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $323.59 Median $575.44 Typical High $1,096.48 | Professional | None | $323.59 | $575.44 | $1,096.48 |
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 $204.17 Median $269.15 Typical High $346.74 | Professional | 52 · Reduced service | $204.17 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $107.15 Typical High $141.25 | Professional | 53 · Discontinued | $81.28 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $407.38 Typical High $524.81 | Professional | 54 · Surgery only | $302.00 | $407.38 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $81.28 Typical High $104.71 | Professional | 55 · Aftercare only | $60.26 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $53.70 Typical High $70.79 | Professional | 56 · Pre-op care only | $40.74 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $380.19 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $281.84 | $380.19 | $489.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $251.19 Median $416.87 Typical High $549.54 | Professional | 51 · Multiple procedures | $251.19 | $416.87 | $549.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $165.96 Typical High $218.78 | Professional | 80 · Assistant surgeon | $100.00 | $165.96 | $218.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $70.79 Median $117.49 Typical High $151.36 | Professional | 81 · Minimal assistant surgeon | $70.79 | $117.49 | $151.36 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $70.79 Median $117.49 Typical High $151.36 | Professional | 82 · Assistant surgeon, no resident | $70.79 | $117.49 | $151.36 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $117.49 Typical High $151.36 | Professional | AS · PA/NP assist | $70.79 | $117.49 | $151.36 |
Where South Carolina sits
The same service costs 4.9 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· 36th of 51
$575
AK $1,862TX $380
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.