How much rates vary
Facilitymedian $2,818 · 10th to 90th $912 to $10,965Professionalmedian $832 · 10th to 90th $427 to $1,230
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 $10,471.29 Typical High $21,877.62 | Facility | None | $794.33 | $10,471.29 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,023.29 | Professional | None | $741.31 | $831.76 | $1,023.29 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $3,548.13 Typical High $10,232.93 | Facility | None | $1,047.13 | $3,548.13 | $10,232.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $426.58 Median $812.83 Typical High $977.24 | Professional | None | $426.58 | $812.83 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $4,677.35 | Facility | None | $630.96 | $2,951.21 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,288.25 | Professional | None | $707.95 | $870.96 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,122.02 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $977.24 Typical High $2,089.30 | Facility | None | $691.83 | $977.24 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,023.29 | Professional | None | $812.83 | $977.24 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $812.83 Typical High $1,318.26 | Professional | None | $75.86 | $812.83 | $1,318.26 |
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 $602.56 Median $794.33 Typical High $1,348.96 | Professional | None | $602.56 | $794.33 | $1,348.96 |
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 $380.19 Median $416.87 Typical High $512.86 | Professional | 52 · Reduced service | $380.19 | $416.87 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $165.96 Typical High $204.17 | Professional | 53 · Discontinued | $151.36 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $758.58 | Professional | 54 · Surgery only | $575.44 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $154.88 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $83.18 Typical High $102.33 | Professional | 56 · Pre-op care only | $75.86 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $707.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $501.19 Typical High $616.60 | Professional | 51 · Multiple procedures | $407.38 | $501.19 | $616.60 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $199.53 Typical High $245.47 | Professional | 80 · Assistant surgeon | $162.18 | $199.53 | $245.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $112.20 Median $141.25 Typical High $173.78 | Professional | 81 · Minimal assistant surgeon | $112.20 | $141.25 | $173.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $112.20 Median $141.25 Typical High $173.78 | Professional | 82 · Assistant surgeon, no resident | $112.20 | $141.25 | $173.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $141.25 Typical High $173.78 | Professional | AS · PA/NP assist | $112.20 | $141.25 | $173.78 |
Where South Carolina sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 36th of 51
$832
AK $2,754NJ $631
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.