How much rates vary
Facilitymedian $2,951 · 10th to 90th $977 to $11,220Professionalmedian $457 · 10th to 90th $93 to $759
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 $10,964.78 Typical High $21,877.62 | Facility | None | $562.34 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $562.34 | Professional | None | $512.86 | $562.34 | $562.34 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $3,630.78 Typical High $10,232.93 | Facility | None | $1,202.26 | $3,630.78 | $10,232.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $912.01 | Professional | None | $436.52 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,235.94 Typical High $4,677.35 | Facility | None | $630.96 | $3,235.94 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $954.99 | Professional | None | $630.96 | $630.96 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $1,047.13 Typical High $2,398.83 | Facility | None | $562.34 | $1,047.13 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $1,071.52 | Professional | None | $562.34 | $676.08 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $371.54 Typical High $602.56 | Professional | None | $79.43 | $371.54 | $602.56 |
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 $426.58 Median $562.34 Typical High $891.25 | Professional | None | $426.58 | $562.34 | $891.25 |
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 $239.88 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $95.50 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $354.81 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $70.79 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $47.86 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $331.13 | $389.05 | $389.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $338.84 Median $380.19 Typical High $537.03 | Professional | 51 · Multiple procedures | $338.84 | $380.19 | $537.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $151.36 Typical High $218.78 | Professional | 80 · Assistant surgeon | $134.90 | $151.36 | $218.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $93.33 Median $104.71 Typical High $151.36 | Professional | 81 · Minimal assistant surgeon | $93.33 | $104.71 | $151.36 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $93.33 Median $104.71 Typical High $151.36 | Professional | 82 · Assistant surgeon, no resident | $93.33 | $104.71 | $151.36 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $104.71 Typical High $151.36 | Professional | AS · PA/NP assist | $93.33 | $104.71 | $151.36 |
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
$525
AK $1,995TX $110
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.