How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,288 to $28,840Professionalmedian $724 · 10th to 90th $105 to $1,148
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 $891.25 Median $9,120.11 Typical High $22,908.68 | Facility | None | $891.25 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,047.13 | Professional | None | $776.25 | $891.25 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,548.82 Median $3,630.78 Typical High $35,481.34 | Facility | None | $1,548.82 | $3,630.78 | $35,481.34 |
BCBS South Carolina Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $1,479.11 | Professional | None | $691.83 | $1,047.13 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,511.89 | Facility | None | $602.56 | $1,862.09 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $954.99 Typical High $1,380.38 | Professional | None | $933.25 | $954.99 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $912.01 Typical High $3,630.78 | Facility | None | $707.95 | $912.01 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,318.26 | Professional | None | $891.25 | $1,122.02 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $562.34 Typical High $954.99 | Professional | None | $79.43 | $562.34 | $954.99 |
United Setting Facility Modifier None Typical Low $3,311.31 Median $11,220.18 Typical High $28,840.32 | Facility | None | $3,311.31 | $11,220.18 | $28,840.32 |
United Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,348.96 | Professional | None | $645.65 | $831.76 | $1,348.96 |
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 $389.05 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $389.05 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $154.88 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $575.44 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $114.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $77.62 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $537.03 | $630.96 | $630.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,698.24 Typical High $2,137.96 | Professional | 50 · Both sides | $1,513.56 | $1,698.24 | $2,137.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $562.34 Typical High $707.95 | Professional | 51 · Multiple procedures | $512.86 | $562.34 | $707.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $229.09 Typical High $281.84 | Professional | 80 · Assistant surgeon | $204.17 | $229.09 | $281.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $141.25 Median $158.49 Typical High $199.53 | Professional | 81 · Minimal assistant surgeon | $141.25 | $158.49 | $199.53 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $158.49 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $158.49 | $199.53 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $158.49 Typical High $199.53 | Professional | AS · PA/NP assist | $141.25 | $158.49 | $199.53 |
Where South Carolina sits
The same service costs 4.3 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 $9,769TX $2,271
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.