How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,413 to $17,378Professionalmedian $912 · 10th to 90th $102 to $1,318
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 $1,148.15 Median $12,022.64 Typical High $21,877.62 | Facility | None | $1,148.15 | $12,022.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,148.15 | Professional | None | $977.24 | $1,148.15 | $1,148.15 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,951.21 Typical High $13,489.63 | Facility | None | $1,778.28 | $2,951.21 | $13,489.63 |
BCBS South Carolina Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,412.54 | Professional | None | $851.14 | $1,096.48 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,235.94 Typical High $4,677.35 | Facility | None | $602.56 | $3,235.94 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,778.28 | Professional | None | $1,096.48 | $1,122.02 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $1,148.15 Typical High $5,248.07 | Facility | None | $812.83 | $1,148.15 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,479.11 | Professional | None | $1,148.15 | $1,288.25 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $707.95 Typical High $1,202.26 | Professional | None | $79.43 | $707.95 | $1,202.26 |
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 $831.76 Median $1,047.13 Typical High $1,737.80 | Professional | None | $831.76 | $1,047.13 | $1,737.80 |
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 $489.78 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $489.78 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $199.53 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $741.31 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $147.91 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $97.72 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $691.83 | $812.83 | $812.83 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $1,949.84 Typical High $2,691.53 | Professional | 50 · Both sides | $1,737.80 | $1,949.84 | $2,691.53 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $660.69 Typical High $891.25 | Professional | 51 · Multiple procedures | $575.44 | $660.69 | $891.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $263.03 Typical High $354.81 | Professional | 80 · Assistant surgeon | $234.42 | $263.03 | $354.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $162.18 Median $181.97 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $162.18 | $181.97 | $251.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $181.97 Typical High $251.19 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $181.97 | $251.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $181.97 Typical High $251.19 | Professional | AS · PA/NP assist | $162.18 | $181.97 | $251.19 |
Where South Carolina sits
The same service costs 18.2 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
$1,000
AK $4,074TX $224
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.