How much rates vary
Facilitymedian $832 · 10th to 90th $468 to $4,074Professionalmedian $269 · 10th to 90th $49 to $457
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 $234.42 Median $4,897.79 Typical High $21,877.62 | Facility | None | $234.42 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $316.23 | Professional | None | $234.42 | $263.03 | $316.23 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $870.96 Typical High $3,162.28 | Facility | None | $512.86 | $870.96 | $3,162.28 |
BCBS South Carolina Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $323.59 | Professional | None | $181.97 | $257.04 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $741.31 Typical High $1,174.90 | Facility | None | $457.09 | $741.31 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $537.03 | Professional | None | $239.88 | $302.00 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $234.42 Median $436.52 Typical High $812.83 | Facility | None | $234.42 | $436.52 | $812.83 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $436.52 | Professional | None | $302.00 | $346.74 | $436.52 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $269.15 Typical High $457.09 | Professional | None | $37.15 | $269.15 | $457.09 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $524.81 | Professional | None | $204.17 | $316.23 | $524.81 |
11 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 $117.49 Median $125.89 Typical High $158.49 | Professional | 52 · Reduced service | $117.49 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $50.12 Typical High $63.10 | Professional | 53 · Discontinued | $46.77 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $186.21 Typical High $234.42 | Professional | 54 · Surgery only | $177.83 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $37.15 Typical High $47.86 | Professional | 55 · Aftercare only | $35.48 | $37.15 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.12 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.44 | $25.12 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $173.78 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $165.96 | $173.78 | $218.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $151.36 Median $173.78 Typical High $234.42 | Professional | 51 · Multiple procedures | $151.36 | $173.78 | $234.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $69.18 Typical High $95.50 | Professional | 80 · Assistant surgeon | $60.26 | $69.18 | $95.50 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $42.66 Median $48.98 Typical High $66.07 | Professional | 81 · Minimal assistant surgeon | $42.66 | $48.98 | $66.07 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $42.66 Median $48.98 Typical High $66.07 | Professional | 82 · Assistant surgeon, no resident | $42.66 | $48.98 | $66.07 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $48.98 Typical High $66.07 | Professional | AS · PA/NP assist | $42.66 | $48.98 | $66.07 |
Where South Carolina sits
The same service costs 4.3 times more in Alaska than in Utah. 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
$302
AK $1,000UT $234
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.