How much rates vary
Facilitymedian $631 · 10th to 90th $102 to $1,995Professionalmedian $162 · 10th to 90th $107 to $251
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 $128.82 Median $4,897.79 Typical High $21,877.62 | Facility | None | $128.82 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $208.93 | Professional | None | $125.89 | $162.18 | $208.93 |
BCBS South Carolina Setting Facility Modifier None Typical Low $501.19 Median $851.14 Typical High $1,584.89 | Facility | None | $501.19 | $851.14 | $1,584.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $93.33 Median $154.88 Typical High $181.97 | Professional | None | $93.33 | $154.88 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $144.54 Typical High $229.09 | Facility | None | $75.86 | $144.54 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $239.88 | Professional | None | $109.65 | $158.49 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $416.87 | Professional | None | $190.55 | $204.17 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $120.23 Median $186.21 Typical High $263.03 | Facility | None | $120.23 | $186.21 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $190.55 Typical High $208.93 | Professional | None | $165.96 | $190.55 | $208.93 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $331.13 | Professional | None | $131.83 | $204.17 | $331.13 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $97.72 Median $158.49 Typical High $239.88 | Professional | None | $97.72 | $158.49 | $239.88 |
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 $63.10 Median $81.28 Typical High $104.71 | Professional | 52 · Reduced service | $63.10 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $32.36 Typical High $41.69 | Professional | 53 · Discontinued | $25.12 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $123.03 Typical High $158.49 | Professional | 54 · Surgery only | $93.33 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $24.55 Typical High $31.62 | Professional | 55 · Aftercare only | $18.62 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.22 Typical High $20.89 | Professional | 56 · Pre-op care only | $12.59 | $16.22 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $114.82 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $87.10 | $114.82 | $147.91 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $95.50 Typical High $125.89 | Professional | 51 · Multiple procedures | $83.18 | $95.50 | $125.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.11 Median $38.02 Typical High $50.12 | Professional | 80 · Assistant surgeon | $33.11 | $38.02 | $50.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $22.91 Median $26.30 Typical High $35.48 | Professional | 81 · Minimal assistant surgeon | $22.91 | $26.30 | $35.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $22.91 Median $26.30 Typical High $35.48 | Professional | 82 · Assistant surgeon, no resident | $22.91 | $26.30 | $35.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $22.91 Median $26.30 Typical High $35.48 | Professional | AS · PA/NP assist | $22.91 | $26.30 | $35.48 |
Where South Carolina sits
The same service costs 3.5 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· 31st of 51
$166
AK $437NJ $126
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.