How much rates vary
Facilitymedian $2,818 · 10th to 90th $794 to $11,220Professionalmedian $708 · 10th to 90th $102 to $1,023
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 $851.14 Median $10,000.00 Typical High $21,877.62 | Facility | None | $851.14 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $851.14 | Professional | None | $724.44 | $851.14 | $851.14 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,890.45 Typical High $10,964.78 | Facility | None | $851.14 | $3,890.45 | $10,964.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,174.90 | Professional | None | $660.69 | $933.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $5,623.41 | Facility | None | $602.56 | $2,398.83 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,318.26 | Professional | None | $831.76 | $831.76 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $2,041.74 | Facility | None | $630.96 | $851.14 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,047.13 | Professional | None | $851.14 | $1,000.00 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $537.03 Typical High $933.25 | Professional | None | $79.43 | $537.03 | $933.25 |
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 $602.56 Median $758.58 Typical High $1,230.27 | Professional | None | $602.56 | $758.58 | $1,230.27 |
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 $363.08 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $363.08 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $144.54 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $537.03 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $107.15 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $72.44 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $501.19 | $588.84 | $588.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,548.82 Typical High $1,949.84 | Professional | 50 · Both sides | $1,318.26 | $1,548.82 | $1,949.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $524.81 Typical High $660.69 | Professional | 51 · Multiple procedures | $436.52 | $524.81 | $660.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $208.93 Typical High $263.03 | Professional | 80 · Assistant surgeon | $173.78 | $208.93 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $144.54 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $123.03 | $144.54 | $181.97 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $144.54 Typical High $181.97 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $144.54 | $181.97 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $144.54 Typical High $181.97 | Professional | AS · PA/NP assist | $123.03 | $144.54 | $181.97 |
Where South Carolina sits
The same service costs 7.6 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· 40th of 51
$794
AK $3,020TX $398
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.