How much rates vary
Facilitymedian $1,995 · 10th to 90th $933 to $12,303Professionalmedian $1,413 · 10th to 90th $158 to $2,089
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 $1,778.28 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,778.28 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,513.56 | $1,778.28 | $1,778.28 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,000.00 Median $1,905.46 Typical High $6,606.93 | Facility | None | $1,000.00 | $1,905.46 | $6,606.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,348.96 | $1,862.09 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,290.87 Typical High $3,162.28 | Facility | None | $602.56 | $2,290.87 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,737.80 | $1,778.28 | $2,754.23 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $4,677.35 | Facility | None | $1,318.26 | $1,778.28 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,137.96 | Professional | None | $1,548.82 | $1,862.09 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $1,096.48 Typical High $1,862.09 | Professional | None | $120.23 | $1,096.48 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,621.81 | $2,630.27 |
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 $758.58 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $758.58 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $302.00 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,122.02 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $223.87 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $151.36 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,230.27 | $1,230.27 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,344.23 Median $3,162.28 Typical High $4,073.80 | Professional | 50 · Both sides | $2,344.23 | $3,162.28 | $4,073.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $776.25 Median $1,071.52 Typical High $1,348.96 | Professional | 51 · Multiple procedures | $776.25 | $1,071.52 | $1,348.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $426.58 Typical High $549.54 | Professional | 80 · Assistant surgeon | $316.23 | $426.58 | $549.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $218.78 Median $295.12 Typical High $380.19 | Professional | 81 · Minimal assistant surgeon | $218.78 | $295.12 | $380.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $218.78 Median $295.12 Typical High $380.19 | Professional | 82 · Assistant surgeon, no resident | $218.78 | $295.12 | $380.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $295.12 Typical High $380.19 | Professional | AS · PA/NP assist | $218.78 | $295.12 | $380.19 |
Where South Carolina sits
The same service costs 16.2 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· 46th of 51
$1,479
AK $6,310TX $389
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.