How much rates vary
Facilitymedian $302 · 10th to 90th $93 to $1,738Professionalmedian $123 · 10th to 90th $50 to $178
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 $114.82 Median $4,897.79 Typical High $21,877.62 | Facility | None | $114.82 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $114.82 Typical High $131.83 | Professional | None | $107.15 | $114.82 | $131.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $251.19 Median $436.52 Typical High $758.58 | Facility | None | $251.19 | $436.52 | $758.58 |
BCBS South Carolina Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $158.49 | Professional | None | $97.72 | $131.83 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $154.88 | Facility | None | $75.86 | $100.00 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $123.03 Typical High $199.53 | Professional | None | $117.49 | $123.03 | $199.53 |
Medcost Setting Facility Modifier None Typical Low $91.20 Median $128.82 Typical High $169.82 | Facility | None | $91.20 | $128.82 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $177.83 | Professional | None | $131.83 | $154.88 | $177.83 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $117.49 Typical High $186.21 | Professional | None | $35.48 | $117.49 | $186.21 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $181.97 | Professional | None | $85.11 | $114.82 | $181.97 |
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 $54.95 Median $57.54 Typical High $66.07 | Professional | 52 · Reduced service | $54.95 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.91 Typical High $26.30 | Professional | 53 · Discontinued | $21.88 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $87.10 Typical High $100.00 | Professional | 54 · Surgery only | $83.18 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.38 Typical High $19.95 | Professional | 55 · Aftercare only | $16.60 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.48 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.96 | $11.48 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $81.28 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $77.62 | $81.28 | $93.33 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $199.53 Median $251.19 Typical High $309.03 | Professional | 50 · Both sides | $199.53 | $251.19 | $309.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $66.07 Median $83.18 Typical High $102.33 | Professional | 51 · Multiple procedures | $66.07 | $83.18 | $102.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.30 Median $33.11 Typical High $40.74 | Professional | 80 · Assistant surgeon | $26.30 | $33.11 | $40.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $18.62 Median $23.44 Typical High $28.84 | Professional | 81 · Minimal assistant surgeon | $18.62 | $23.44 | $28.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $18.62 Median $23.44 Typical High $28.84 | Professional | 82 · Assistant surgeon, no resident | $18.62 | $23.44 | $28.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $18.62 Median $23.44 Typical High $28.84 | Professional | AS · PA/NP assist | $18.62 | $23.44 | $28.84 |
Where South Carolina sits
The same service costs 4.5 times more in Alaska than in Florida. 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· 36th of 51
$123
AK $427FL $95.50
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.