How much rates vary
Facilitymedian $2,512 · 10th to 90th $794 to $10,965Professionalmedian $813 · 10th to 90th $107 to $1,380
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 $794.33 Median $9,120.11 Typical High $21,877.62 | Facility | None | $794.33 | $9,120.11 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $1,096.48 | Professional | None | $776.25 | $851.14 | $1,096.48 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,388.44 Typical High $10,232.93 | Facility | None | $851.14 | $3,388.44 | $10,232.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $1,000.00 | Professional | None | $524.81 | $758.58 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $4,677.35 | Facility | None | $602.56 | $2,398.83 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,698.24 | Professional | None | $660.69 | $831.76 | $1,698.24 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $933.25 Typical High $2,344.23 | Facility | None | $616.60 | $933.25 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,230.27 | Professional | None | $812.83 | $912.01 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $870.96 Typical High $1,412.54 | Professional | None | $81.28 | $870.96 | $1,412.54 |
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 $645.65 Median $912.01 Typical High $1,513.56 | Professional | None | $645.65 | $912.01 | $1,513.56 |
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 $389.05 Median $416.87 Typical High $549.54 | Professional | 52 · Reduced service | $389.05 | $416.87 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $218.78 | Professional | 53 · Discontinued | $154.88 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $812.83 | Professional | 54 · Surgery only | $575.44 | $630.96 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $165.96 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $109.65 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $758.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $457.09 Typical High $794.33 | Professional | 51 · Multiple procedures | $407.38 | $457.09 | $794.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $181.97 Typical High $316.23 | Professional | 80 · Assistant surgeon | $165.96 | $181.97 | $316.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $128.82 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $114.82 | $128.82 | $223.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $128.82 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $128.82 | $223.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $128.82 Typical High $223.87 | Professional | AS · PA/NP assist | $114.82 | $128.82 | $223.87 |
Where South Carolina sits
The same service costs 5.2 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· 45th of 51
$871
AK $3,548UT $676
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.