How much rates vary
Facilitymedian $631 · 10th to 90th $224 to $1,622Professionalmedian $240 · 10th to 90th $69 to $347
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 $213.80 Median $4,897.79 Typical High $21,877.62 | Facility | None | $213.80 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $309.03 | Professional | None | $199.53 | $245.47 | $309.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $457.09 Median $741.31 Typical High $1,412.54 | Facility | None | $457.09 | $741.31 | $1,412.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $245.47 | Professional | None | $154.88 | $218.78 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $457.09 Typical High $741.31 | Facility | None | $331.13 | $457.09 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $371.54 | Professional | None | $186.21 | $251.19 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $630.96 | Professional | None | $316.23 | $338.84 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $162.18 Median $371.54 Typical High $630.96 | Facility | None | $162.18 | $371.54 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $302.00 | Professional | None | $245.47 | $302.00 | $302.00 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $218.78 Typical High $371.54 | Professional | None | $33.88 | $218.78 | $371.54 |
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 $158.49 Median $239.88 Typical High $380.19 | Professional | None | $158.49 | $239.88 | $380.19 |
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 $100.00 Median $120.23 Typical High $154.88 | Professional | 52 · Reduced service | $100.00 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $48.98 Typical High $61.66 | Professional | 53 · Discontinued | $39.81 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $181.97 Typical High $234.42 | Professional | 54 · Surgery only | $151.36 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $37.15 Typical High $46.77 | Professional | 55 · Aftercare only | $30.20 | $37.15 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $24.55 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.95 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $169.82 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $141.25 | $169.82 | $218.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $123.03 Median $151.36 Typical High $186.21 | Professional | 51 · Multiple procedures | $123.03 | $151.36 | $186.21 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $60.26 Typical High $74.13 | Professional | 80 · Assistant surgeon | $48.98 | $60.26 | $74.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $34.67 Median $42.66 Typical High $52.48 | Professional | 81 · Minimal assistant surgeon | $34.67 | $42.66 | $52.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $34.67 Median $42.66 Typical High $52.48 | Professional | 82 · Assistant surgeon, no resident | $34.67 | $42.66 | $52.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $42.66 Typical High $52.48 | Professional | AS · PA/NP assist | $34.67 | $42.66 | $52.48 |
Where South Carolina sits
The same service costs 4.2 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· 35th of 51
$245
AK $741TX $178
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.