How much rates vary
Facilitymedian $1,905 · 10th to 90th $759 to $10,233Professionalmedian $457 · 10th to 90th $89 to $676
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 $549.54 Median $10,000.00 Typical High $21,877.62 | Facility | None | $549.54 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | None | $467.74 | $549.54 | $549.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $8,912.51 | Facility | None | $851.14 | $2,818.38 | $8,912.51 |
BCBS South Carolina Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $602.56 | Professional | None | $416.87 | $457.09 | $602.56 |
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 $524.81 Median $537.03 Typical High $851.14 | Professional | None | $524.81 | $537.03 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $741.31 Typical High $1,698.24 | Facility | None | $537.03 | $741.31 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $691.83 | Professional | None | $489.78 | $562.34 | $691.83 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $398.11 Typical High $616.60 | Professional | None | $77.62 | $398.11 | $616.60 |
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 $389.05 Median $489.78 Typical High $812.83 | Professional | None | $389.05 | $489.78 | $812.83 |
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 $234.42 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $234.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $346.74 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $70.79 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $46.77 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $323.59 | $380.19 | $380.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $245.47 Median $338.84 Typical High $426.58 | Professional | 51 · Multiple procedures | $245.47 | $338.84 | $426.58 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $138.04 Typical High $169.82 | Professional | 80 · Assistant surgeon | $97.72 | $138.04 | $169.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $69.18 Median $95.50 Typical High $120.23 | Professional | 81 · Minimal assistant surgeon | $69.18 | $95.50 | $120.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $69.18 Median $95.50 Typical High $120.23 | Professional | 82 · Assistant surgeon, no resident | $69.18 | $95.50 | $120.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $95.50 Typical High $120.23 | Professional | AS · PA/NP assist | $69.18 | $95.50 | $120.23 |
Where South Carolina sits
The same service costs 4.6 times more in Alabama than in Montana. 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.
Physician feeFacility fee
AL $7,006MT $1,517
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.