How much rates vary
Facilitymedian $1,778 · 10th to 90th $676 to $8,511Professionalmedian $1,202 · 10th to 90th $151 to $1,778
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 $1,513.56 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,513.56 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,318.26 | $1,513.56 | $1,513.56 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $2,137.96 Typical High $8,317.64 | Facility | None | $851.14 | $2,137.96 | $8,317.64 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,288.25 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,380.38 Typical High $2,238.72 | Facility | None | $602.56 | $1,380.38 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,122.02 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $831.76 Typical High $2,041.74 | Facility | None | $630.96 | $831.76 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,318.26 | $1,513.56 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $1,000.00 Typical High $1,698.24 | Professional | None | $120.23 | $1,000.00 | $1,698.24 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,318.26 | $2,137.96 |
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 $660.69 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $660.69 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $263.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,000.00 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $199.53 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $131.83 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $933.25 | $1,071.52 | $1,071.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,344.23 Typical High $3,548.13 | Professional | 50 · Both sides | $1,995.26 | $2,344.23 | $3,548.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $660.69 Median $776.25 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $660.69 | $776.25 | $1,174.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $309.03 Typical High $478.63 | Professional | 80 · Assistant surgeon | $263.03 | $309.03 | $478.63 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $218.78 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $186.21 | $218.78 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $218.78 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $218.78 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $218.78 Typical High $331.13 | Professional | AS · PA/NP assist | $186.21 | $218.78 | $331.13 |
Where South Carolina sits
The same service costs 3.7 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 $8,917DE $2,410
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.