How much rates vary
Facilitymedian $1,905 · 10th to 90th $912 to $10,965Professionalmedian $269 · 10th to 90th $195 to $363
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 $288.40 Median $10,964.78 Typical High $21,877.62 | Facility | None | $288.40 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $288.40 | Professional | None | $239.88 | $288.40 | $288.40 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $3,388.44 Typical High $10,232.93 | Facility | None | $1,047.13 | $3,388.44 | $10,232.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $316.23 | Professional | None | $213.80 | $309.03 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,621.81 Typical High $2,691.53 | Facility | None | $630.96 | $1,621.81 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $257.04 Typical High $407.38 | Professional | None | $251.19 | $257.04 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $575.44 | Professional | None | $346.74 | $371.54 | $575.44 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $812.83 Typical High $1,949.84 | Facility | None | $275.42 | $812.83 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $338.84 | Professional | None | $257.04 | $302.00 | $338.84 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $338.84 | Professional | None | $162.18 | $218.78 | $338.84 |
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 $204.17 Median $251.19 Typical High $426.58 | Professional | None | $204.17 | $251.19 | $426.58 |
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 $120.23 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $120.23 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $47.86 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $177.83 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $35.48 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $23.99 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $204.17 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $165.96 | $204.17 | $204.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $165.96 Typical High $177.83 | Professional | 51 · Multiple procedures | $128.82 | $165.96 | $177.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $66.07 Typical High $70.79 | Professional | 80 · Assistant surgeon | $51.29 | $66.07 | $70.79 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $36.31 Median $46.77 Typical High $48.98 | Professional | 81 · Minimal assistant surgeon | $36.31 | $46.77 | $48.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $36.31 Median $46.77 Typical High $48.98 | Professional | 82 · Assistant surgeon, no resident | $36.31 | $46.77 | $48.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $46.77 Typical High $48.98 | Professional | AS · PA/NP assist | $36.31 | $46.77 | $48.98 |
Where South Carolina sits
The same service costs 6.0 times more in Alaska than in Utah. 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
$288
AK $1,000UT $166
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.