How much rates vary
Facilitymedian $3,467 · 10th to 90th $977 to $17,783Professionalmedian $891 · 10th to 90th $110 to $1,202
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 $977.24 Median $10,964.78 Typical High $21,877.62 | Facility | None | $977.24 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $977.24 | Professional | None | $812.83 | $977.24 | $977.24 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $5,495.41 Typical High $17,378.01 | Facility | None | $1,047.13 | $5,495.41 | $17,378.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $691.83 Median $954.99 Typical High $977.24 | Professional | None | $691.83 | $954.99 | $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 $891.25 Median $912.01 Typical High $1,380.38 | Professional | None | $891.25 | $912.01 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,202.26 | $1,949.84 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $977.24 Typical High $2,344.23 | Facility | None | $758.58 | $977.24 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,318.26 | Professional | None | $933.25 | $1,047.13 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $691.83 Typical High $1,148.15 | Professional | None | $75.86 | $691.83 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,479.11 | Professional | None | $691.83 | $831.76 | $1,479.11 |
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 $398.11 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $398.11 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $162.18 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $602.56 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $676.08 | $676.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $537.03 Typical High $758.58 | Professional | 51 · Multiple procedures | $524.81 | $537.03 | $758.58 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $213.80 Typical High $302.00 | Professional | 80 · Assistant surgeon | $208.93 | $213.80 | $302.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $144.54 Median $151.36 Typical High $213.80 | Professional | 81 · Minimal assistant surgeon | $144.54 | $151.36 | $213.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $144.54 Median $151.36 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $144.54 | $151.36 | $213.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $151.36 Typical High $213.80 | Professional | AS · PA/NP assist | $144.54 | $151.36 | $213.80 |
Where South Carolina sits
The same service costs 6.5 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
$912
AK $3,311TX $513
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.