How much rates vary
Facilitymedian $1,738 · 10th to 90th $501 to $9,772Professionalmedian $398 · 10th to 90th $49 to $575
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 $478.63 Median $5,623.41 Typical High $21,877.62 | Facility | None | $478.63 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $478.63 | Professional | None | $407.38 | $478.63 | $478.63 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,737.80 Typical High $8,912.51 | Facility | None | $512.86 | $1,737.80 | $8,912.51 |
BCBS South Carolina Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $588.84 | Professional | None | $389.05 | $467.74 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,479.11 Typical High $2,511.89 | Facility | None | $457.09 | $1,479.11 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $758.58 | Professional | None | $446.68 | $446.68 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $537.03 Typical High $1,174.90 | Facility | None | $407.38 | $537.03 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $575.44 | Professional | None | $478.63 | $549.54 | $575.44 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $309.03 Typical High $537.03 | Professional | None | $38.90 | $309.03 | $537.03 |
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 $338.84 Median $436.52 Typical High $707.95 | Professional | None | $338.84 | $436.52 | $707.95 |
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 $204.17 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $204.17 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $83.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $309.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $61.66 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $40.74 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $338.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $288.40 | $338.84 | $338.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $851.14 Typical High $1,122.02 | Professional | 50 · Both sides | $724.44 | $851.14 | $1,122.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $239.88 Median $281.84 Typical High $371.54 | Professional | 51 · Multiple procedures | $239.88 | $281.84 | $371.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $112.20 Typical High $151.36 | Professional | 80 · Assistant surgeon | $95.50 | $112.20 | $151.36 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $67.61 Median $79.43 Typical High $104.71 | Professional | 81 · Minimal assistant surgeon | $67.61 | $79.43 | $104.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $67.61 Median $79.43 Typical High $104.71 | Professional | 82 · Assistant surgeon, no resident | $67.61 | $79.43 | $104.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $79.43 Typical High $104.71 | Professional | AS · PA/NP assist | $67.61 | $79.43 | $104.71 |
Where South Carolina sits
The same service costs 8.3 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· 42nd of 51
$447
AK $1,738TX $209
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.