How much rates vary
Facilitymedian $1,349 · 10th to 90th $603 to $7,244Professionalmedian $562 · 10th to 90th $123 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 $524.81 Median $5,623.41 Typical High $21,877.62 | Facility | None | $524.81 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $831.76 | Professional | None | $524.81 | $645.65 | $831.76 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,778.28 Typical High $7,079.46 | Facility | None | $691.83 | $1,778.28 | $7,079.46 |
BCBS South Carolina Setting Professional Modifier None Typical Low $169.82 Median $426.58 Typical High $707.95 | Professional | None | $169.82 | $426.58 | $707.95 |
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 $363.08 Median $691.83 Typical High $1,071.52 | Professional | None | $363.08 | $691.83 | $1,071.52 |
Medcost Setting Facility Modifier None Typical Low $338.84 Median $691.83 Typical High $1,479.11 | Facility | None | $338.84 | $691.83 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $977.24 | Professional | None | $549.54 | $676.08 | $977.24 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $575.44 Typical High $977.24 | Professional | None | $77.62 | $575.44 | $977.24 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $338.84 Median $562.34 Typical High $1,000.00 | Professional | None | $338.84 | $562.34 | $1,000.00 |
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 $263.03 Median $309.03 Typical High $416.87 | Professional | 52 · Reduced service | $263.03 | $309.03 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $123.03 Typical High $165.96 | Professional | 53 · Discontinued | $104.71 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $467.74 Typical High $630.96 | Professional | 54 · Surgery only | $389.05 | $467.74 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $93.33 Typical High $125.89 | Professional | 55 · Aftercare only | $77.62 | $93.33 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $61.66 Typical High $83.18 | Professional | 56 · Pre-op care only | $52.48 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $436.52 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $363.08 | $436.52 | $588.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $338.84 Typical High $645.65 | Professional | 51 · Multiple procedures | $275.42 | $338.84 | $645.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $134.90 Typical High $257.04 | Professional | 80 · Assistant surgeon | $109.65 | $134.90 | $257.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $75.86 Median $95.50 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $75.86 | $95.50 | $181.97 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $75.86 Median $95.50 Typical High $181.97 | Professional | 82 · Assistant surgeon, no resident | $75.86 | $95.50 | $181.97 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $95.50 Typical High $181.97 | Professional | AS · PA/NP assist | $75.86 | $95.50 | $181.97 |
Where South Carolina sits
The same service costs 5.9 times more in Alaska than in Kentucky. 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· 40th of 51
$589
AK $2,138KY $363
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.