How much rates vary
Facilitymedian $2,818 · 10th to 90th $759 to $11,220Professionalmedian $363 · 10th to 90th $49 to $550
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 $446.68 Median $10,000.00 Typical High $21,877.62 | Facility | None | $446.68 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $446.68 | Professional | None | $380.19 | $446.68 | $446.68 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,890.45 Typical High $10,964.78 | Facility | None | $851.14 | $3,890.45 | $10,964.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $467.74 | Professional | None | $346.74 | $380.19 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $5,623.41 | Facility | None | $602.56 | $2,398.83 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $416.87 Typical High $691.83 | Professional | None | $407.38 | $416.87 | $691.83 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $660.69 Typical High $1,698.24 | Facility | None | $446.68 | $660.69 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $812.83 | Professional | None | $436.52 | $512.86 | $812.83 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $309.03 Typical High $512.86 | Professional | None | $38.90 | $309.03 | $512.86 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $660.69 | Professional | None | $316.23 | $398.11 | $660.69 |
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 $186.21 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $186.21 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $75.86 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $281.84 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $56.23 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.02 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $309.03 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $263.03 | $309.03 | $309.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $831.76 Typical High $1,230.27 | Professional | 50 · Both sides | $645.65 | $831.76 | $1,230.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $275.42 Typical High $407.38 | Professional | 51 · Multiple procedures | $218.78 | $275.42 | $407.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $112.20 Typical High $162.18 | Professional | 80 · Assistant surgeon | $87.10 | $112.20 | $162.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $60.26 Median $77.62 Typical High $114.82 | Professional | 81 · Minimal assistant surgeon | $60.26 | $77.62 | $114.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $60.26 Median $77.62 Typical High $114.82 | Professional | 82 · Assistant surgeon, no resident | $60.26 | $77.62 | $114.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $77.62 Typical High $114.82 | Professional | AS · PA/NP assist | $60.26 | $77.62 | $114.82 |
Where South Carolina sits
The same service costs 7.2 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· 43rd of 51
$398
AK $1,622TX $224
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.