How much rates vary
Facilitymedian $1,349 · 10th to 90th $490 to $7,079Professionalmedian $501 · 10th to 90th $288 to $794
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 $426.58 Median $4,897.79 Typical High $21,877.62 | Facility | None | $426.58 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $645.65 | Professional | None | $398.11 | $489.78 | $645.65 |
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 $478.63 Typical High $512.86 | Professional | None | $309.03 | $478.63 | $512.86 |
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 $371.54 Median $489.78 Typical High $707.95 | Professional | None | $371.54 | $489.78 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $1,288.25 | Professional | None | $575.44 | $616.60 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $562.34 Typical High $1,096.48 | Facility | None | $380.19 | $562.34 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $645.65 | Professional | None | $537.03 | $575.44 | $645.65 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $549.54 Typical High $912.01 | Professional | None | $37.15 | $549.54 | $912.01 |
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 $316.23 Median $478.63 Typical High $758.58 | Professional | None | $316.23 | $478.63 | $758.58 |
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 $199.53 Median $245.47 Typical High $323.59 | Professional | 52 · Reduced service | $199.53 | $245.47 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $97.72 Typical High $128.82 | Professional | 53 · Discontinued | $79.43 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $363.08 Typical High $489.78 | Professional | 54 · Surgery only | $302.00 | $363.08 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $74.13 Typical High $97.72 | Professional | 55 · Aftercare only | $60.26 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $48.98 Typical High $64.57 | Professional | 56 · Pre-op care only | $39.81 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $338.84 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $281.84 | $338.84 | $457.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $269.15 Median $288.40 Typical High $389.05 | Professional | 51 · Multiple procedures | $269.15 | $288.40 | $389.05 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $114.82 Typical High $154.88 | Professional | 80 · Assistant surgeon | $107.15 | $114.82 | $154.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $74.13 Median $81.28 Typical High $109.65 | Professional | 81 · Minimal assistant surgeon | $74.13 | $81.28 | $109.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $74.13 Median $81.28 Typical High $109.65 | Professional | 82 · Assistant surgeon, no resident | $74.13 | $81.28 | $109.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $81.28 Typical High $109.65 | Professional | AS · PA/NP assist | $74.13 | $81.28 | $109.65 |
Where South Carolina sits
The same service costs 3.7 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· 34th of 51
$501
AK $1,445NJ $389
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.