How much rates vary
Facilitymedian $2,042 · 10th to 90th $794 to $13,183Professionalmedian $575 · 10th to 90th $98 to $832
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 $707.95 Median $10,000.00 Typical High $21,877.62 | Facility | None | $707.95 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $707.95 | Professional | None | $616.60 | $707.95 | $707.95 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,235.94 Typical High $12,589.25 | Facility | None | $851.14 | $3,235.94 | $12,589.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $870.96 | Professional | None | $562.34 | $691.83 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,511.89 | Facility | None | $602.56 | $1,778.28 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,122.02 | Professional | None | $676.08 | $676.08 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $794.33 Typical High $1,737.80 | Facility | None | $616.60 | $794.33 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,000.00 | Professional | None | $707.95 | $831.76 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $446.68 Typical High $776.25 | Professional | None | $79.43 | $446.68 | $776.25 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $1,047.13 | Professional | None | $512.86 | $645.65 | $1,047.13 |
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 $309.03 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $309.03 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $123.03 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $457.09 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $91.20 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $61.66 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $426.58 | $501.19 | $501.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,230.27 Typical High $1,659.59 | Professional | 50 · Both sides | $1,096.48 | $1,230.27 | $1,659.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $416.87 Typical High $549.54 | Professional | 51 · Multiple procedures | $363.08 | $416.87 | $549.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $165.96 Typical High $223.87 | Professional | 80 · Assistant surgeon | $144.54 | $165.96 | $223.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $114.82 Typical High $154.88 | Professional | 81 · Minimal assistant surgeon | $102.33 | $114.82 | $154.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $114.82 Typical High $154.88 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $114.82 | $154.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $114.82 Typical High $154.88 | Professional | AS · PA/NP assist | $102.33 | $114.82 | $154.88 |
Where South Carolina sits
The same service costs 7.8 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· 41st of 51
$661
AK $2,570TX $331
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.