How much rates vary
Facilitymedian $3,802 · 10th to 90th $977 to $13,183Professionalmedian $933 · 10th to 90th $151 to $1,380
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 $1,202.26 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,202.26 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,202.26 | $1,202.26 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $4,073.80 Typical High $11,481.54 | Facility | None | $1,047.13 | $4,073.80 | $11,481.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,202.26 | Professional | None | $891.25 | $977.24 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,981.07 Typical High $5,623.41 | Facility | None | $630.96 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,148.15 | $1,737.80 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,202.26 Typical High $3,162.28 | Facility | None | $794.33 | $1,202.26 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $1,380.38 | Professional | None | $1,148.15 | $1,202.26 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $758.58 Typical High $1,318.26 | Professional | None | $117.49 | $758.58 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,659.59 | Professional | None | $812.83 | $1,047.13 | $1,659.59 |
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 $512.86 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $512.86 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $204.17 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $758.58 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $102.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $707.95 | $831.76 | $831.76 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,089.30 Typical High $2,754.23 | Professional | 50 · Both sides | $1,737.80 | $2,089.30 | $2,754.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $691.83 Typical High $933.25 | Professional | 51 · Multiple procedures | $575.44 | $691.83 | $933.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $275.42 Typical High $371.54 | Professional | 80 · Assistant surgeon | $229.09 | $275.42 | $371.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $162.18 Median $194.98 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $162.18 | $194.98 | $257.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $194.98 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $194.98 | $257.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $194.98 Typical High $257.04 | Professional | AS · PA/NP assist | $162.18 | $194.98 | $257.04 |
Where South Carolina sits
The same service costs 3.9 times more in Alaska than in Delaware. 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
AK $12,209DE $3,093
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.