How much rates vary
Facilitymedian $933 · 10th to 90th $589 to $3,802Professionalmedian $603 · 10th to 90th $107 to $871
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 $660.69 Median $9,120.11 Typical High $22,908.68 | Facility | None | $660.69 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $660.69 | Professional | None | $562.34 | $660.69 | $660.69 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $1,148.15 Typical High $3,162.28 | Facility | None | $676.08 | $1,148.15 | $3,162.28 |
BCBS South Carolina Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $758.58 | Professional | None | $524.81 | $724.44 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $741.31 Typical High $1,174.90 | Facility | None | $457.09 | $741.31 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $575.44 Typical High $912.01 | Professional | None | $562.34 | $575.44 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,318.26 | Professional | None | $758.58 | $812.83 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $1,148.15 | Facility | None | $501.19 | $724.44 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,000.00 | Professional | None | $645.65 | $660.69 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $524.81 Typical High $870.96 | Professional | None | $75.86 | $524.81 | $870.96 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $977.24 | Professional | None | $457.09 | $562.34 | $977.24 |
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 $275.42 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $275.42 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $112.20 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $416.87 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $83.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $56.23 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $389.05 | $467.74 | $467.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $331.13 Median $363.08 Typical High $524.81 | Professional | 51 · Multiple procedures | $331.13 | $363.08 | $524.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $147.91 Typical High $213.80 | Professional | 80 · Assistant surgeon | $131.83 | $147.91 | $213.80 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $91.20 Median $102.33 Typical High $147.91 | Professional | 81 · Minimal assistant surgeon | $91.20 | $102.33 | $147.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $91.20 Median $102.33 Typical High $147.91 | Professional | 82 · Assistant surgeon, no resident | $91.20 | $102.33 | $147.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $102.33 Typical High $147.91 | Professional | AS · PA/NP assist | $91.20 | $102.33 | $147.91 |
Where South Carolina sits
The same service costs 5.5 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
$631
AK $2,188TX $398
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.