How much rates vary
Facilitymedian $2,884 · 10th to 90th $912 to $11,220Professionalmedian $603 · 10th to 90th $93 to $933
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 $776.25 Median $10,964.78 Typical High $21,877.62 | Facility | None | $776.25 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $776.25 | Professional | None | $660.69 | $776.25 | $776.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $3,548.13 Typical High $10,232.93 | Facility | None | $1,047.13 | $3,548.13 | $10,232.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $812.83 | Professional | None | $588.84 | $616.60 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $4,677.35 | Facility | None | $630.96 | $2,951.21 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,288.25 | Professional | None | $812.83 | $891.25 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $912.01 Typical High $2,344.23 | Facility | None | $758.58 | $912.01 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,096.48 | Professional | None | $724.44 | $870.96 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $512.86 Typical High $851.14 | Professional | None | $79.43 | $512.86 | $851.14 |
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 $537.03 Median $724.44 Typical High $1,202.26 | Professional | None | $537.03 | $724.44 | $1,202.26 |
12 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 $331.13 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $331.13 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $131.83 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $489.78 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $97.72 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $66.07 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $457.09 | $537.03 | $537.03 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 59 · Distinct service | $660.69 | $660.69 | $660.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $478.63 Typical High $588.84 | Professional | 51 · Multiple procedures | $363.08 | $478.63 | $588.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $190.55 Typical High $239.88 | Professional | 80 · Assistant surgeon | $144.54 | $190.55 | $239.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $100.00 Median $134.90 Typical High $165.96 | Professional | 81 · Minimal assistant surgeon | $100.00 | $134.90 | $165.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $100.00 Median $134.90 Typical High $165.96 | Professional | 82 · Assistant surgeon, no resident | $100.00 | $134.90 | $165.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $134.90 Typical High $165.96 | Professional | AS · PA/NP assist | $100.00 | $134.90 | $165.96 |
Where South Carolina sits
The same service costs 8.1 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· 43rd of 51
$661
AK $2,754TX $339
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.