How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,122 to $11,220Professionalmedian $1,445 · 10th to 90th $204 to $2,138
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 $1,819.70 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,819.70 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,548.82 | $1,819.70 | $1,819.70 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,311.31 Median $5,011.87 Typical High $7,079.46 | Facility | None | $3,311.31 | $5,011.87 | $7,079.46 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,380.38 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,949.84 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $7,413.10 Typical High $10,471.29 | Facility | None | $602.56 | $7,413.10 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,884.03 | Professional | None | $1,819.70 | $1,819.70 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $1,348.96 Median $1,819.70 Typical High $8,709.64 | Facility | None | $1,348.96 | $1,819.70 | $8,709.64 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,344.23 | Professional | None | $1,819.70 | $2,041.74 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $1,122.02 Typical High $1,905.46 | Professional | None | $162.18 | $1,122.02 | $1,905.46 |
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 $1,318.26 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,659.59 | $2,691.53 |
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 $776.25 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $776.25 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $309.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,174.90 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $234.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $154.88 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,258.93 | $1,258.93 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,884.03 Median $3,235.94 Typical High $4,265.80 | Professional | 50 · Both sides | $2,884.03 | $3,235.94 | $4,265.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $977.24 Median $1,071.52 Typical High $1,412.54 | Professional | 51 · Multiple procedures | $977.24 | $1,071.52 | $1,412.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $426.58 Typical High $562.34 | Professional | 80 · Assistant surgeon | $389.05 | $426.58 | $562.34 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $269.15 Median $302.00 Typical High $398.11 | Professional | 81 · Minimal assistant surgeon | $269.15 | $302.00 | $398.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $269.15 Median $302.00 Typical High $398.11 | Professional | 82 · Assistant surgeon, no resident | $269.15 | $302.00 | $398.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $302.00 Typical High $398.11 | Professional | AS · PA/NP assist | $269.15 | $302.00 | $398.11 |
Where South Carolina sits
The same service costs 6.3 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.
Physician feeFacility fee
AK $16,928TX $2,675
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.