How much rates vary
Facilitymedian $1,445 · 10th to 90th $490 to $7,244Professionalmedian $437 · 10th to 90th $52 to $646
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 $537.03 Median $5,623.41 Typical High $21,877.62 | Facility | None | $537.03 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $537.03 | Professional | None | $446.68 | $537.03 | $537.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,513.56 Typical High $7,079.46 | Facility | None | $512.86 | $1,513.56 | $7,079.46 |
BCBS South Carolina Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $436.52 | Professional | None | $309.03 | $407.38 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,479.11 Typical High $2,290.87 | Facility | None | $457.09 | $1,479.11 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $724.44 | Professional | None | $457.09 | $457.09 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $380.19 Typical High $1,096.48 | Professional | None | $354.81 | $380.19 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $537.03 Typical High $1,230.27 | Facility | None | $407.38 | $537.03 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $645.65 | Professional | None | $338.84 | $501.19 | $645.65 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $398.11 Typical High $645.65 | Professional | None | $37.15 | $398.11 | $645.65 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $776.25 | Professional | None | $354.81 | $446.68 | $776.25 |
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 $223.87 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $223.87 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $89.13 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $331.13 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $66.07 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $44.67 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $309.03 | $371.54 | $371.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $251.19 Typical High $346.74 | Professional | 51 · Multiple procedures | $169.82 | $251.19 | $346.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $100.00 Typical High $141.25 | Professional | 80 · Assistant surgeon | $69.18 | $100.00 | $141.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $47.86 Median $70.79 Typical High $97.72 | Professional | 81 · Minimal assistant surgeon | $47.86 | $70.79 | $97.72 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $47.86 Median $70.79 Typical High $97.72 | Professional | 82 · Assistant surgeon, no resident | $47.86 | $70.79 | $97.72 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $70.79 Typical High $97.72 | Professional | AS · PA/NP assist | $47.86 | $70.79 | $97.72 |
Where South Carolina sits
The same service costs 6.2 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
$437
AK $1,862TX $302
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.