How much rates vary
Facilitymedian $891 · 10th to 90th $100 to $2,570Professionalmedian $219 · 10th to 90th $58 to $331
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 $229.09 Median $4,897.79 Typical High $21,877.62 | Facility | None | $229.09 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $269.15 | Professional | None | $223.87 | $229.09 | $269.15 |
BCBS South Carolina Setting Facility Modifier None Typical Low $724.44 Median $1,258.93 Typical High $2,754.23 | Facility | None | $724.44 | $1,258.93 | $2,754.23 |
BCBS South Carolina Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $263.03 | Professional | None | $165.96 | $218.78 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $151.36 Typical High $245.47 | Facility | None | $75.86 | $151.36 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $380.19 | Professional | None | $181.97 | $199.53 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $141.25 Typical High $309.03 | Facility | None | $95.50 | $141.25 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $316.23 | Professional | None | $181.97 | $263.03 | $316.23 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $213.80 Typical High $346.74 | Professional | None | $37.15 | $213.80 | $346.74 |
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 $147.91 Median $199.53 Typical High $331.13 | Professional | None | $147.91 | $199.53 | $331.13 |
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 $109.65 Median $112.20 Typical High $134.90 | Professional | 52 · Reduced service | $109.65 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $45.71 Typical High $53.70 | Professional | 53 · Discontinued | $43.65 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $169.82 Typical High $204.17 | Professional | 54 · Surgery only | $165.96 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $33.11 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $22.91 Typical High $26.92 | Professional | 56 · Pre-op care only | $21.88 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $158.49 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $154.88 | $158.49 | $190.55 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $389.05 Typical High $630.96 | Professional | 50 · Both sides | $269.15 | $389.05 | $630.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $91.20 Median $131.83 Typical High $208.93 | Professional | 51 · Multiple procedures | $91.20 | $131.83 | $208.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $36.31 Median $52.48 Typical High $83.18 | Professional | 80 · Assistant surgeon | $36.31 | $52.48 | $83.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $25.12 Median $36.31 Typical High $58.88 | Professional | 81 · Minimal assistant surgeon | $25.12 | $36.31 | $58.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $25.12 Median $36.31 Typical High $58.88 | Professional | 82 · Assistant surgeon, no resident | $25.12 | $36.31 | $58.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $25.12 Median $36.31 Typical High $58.88 | Professional | AS · PA/NP assist | $25.12 | $36.31 | $58.88 |
Where South Carolina sits
The same service costs 5.0 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· 40th of 51
$219
AK $832FL $166
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.