How much rates vary
Facilitymedian $2,884 · 10th to 90th $676 to $14,791Professionalmedian $1,047 · 10th to 90th $158 to $1,479
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 $1,288.25 Median $5,888.44 Typical High $21,877.62 | Facility | None | $1,288.25 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,288.25 | $1,288.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $3,235.94 Typical High $13,182.57 | Facility | None | $691.83 | $3,235.94 | $13,182.57 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,047.13 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $13,489.63 | Facility | None | $602.56 | $1,995.26 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,258.93 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $3,162.28 | Facility | None | $588.84 | $851.14 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,318.26 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $831.76 Typical High $1,412.54 | Professional | None | $120.23 | $831.76 | $1,412.54 |
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 $954.99 Median $1,202.26 Typical High $1,995.26 | Professional | None | $954.99 | $1,202.26 | $1,995.26 |
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 $562.34 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $562.34 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $223.87 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $831.76 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $165.96 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $112.20 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $776.25 | $912.01 | $912.01 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,089.30 Typical High $3,019.95 | Professional | 50 · Both sides | $1,621.81 | $2,089.30 | $3,019.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $691.83 Typical High $1,000.00 | Professional | 51 · Multiple procedures | $537.03 | $691.83 | $1,000.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $275.42 Typical High $407.38 | Professional | 80 · Assistant surgeon | $213.80 | $275.42 | $407.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $194.98 Typical High $281.84 | Professional | 81 · Minimal assistant surgeon | $151.36 | $194.98 | $281.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $194.98 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $194.98 | $281.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $194.98 Typical High $281.84 | Professional | AS · PA/NP assist | $151.36 | $194.98 | $281.84 |
Where South Carolina sits
The same service costs 6.9 times more in Alaska than in Hawaii. 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 $18,481HI $2,671
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.