How much rates vary
Facilitymedian $912 · 10th to 90th $457 to $8,511Professionalmedian $3,236 · 10th to 90th $389 to $5,129
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 $4,168.69 Median $9,120.11 Typical High $22,908.68 | Facility | None | $4,168.69 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $4,168.69 | Professional | None | $3,548.13 | $4,168.69 | $4,168.69 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2,691.53 Median $3,019.95 Typical High $3,467.37 | Professional | None | $2,691.53 | $3,019.95 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $3,630.78 Typical High $5,888.44 | Professional | None | $2,691.53 | $3,630.78 | $5,888.44 |
Medcost Setting Professional Modifier None Typical Low $2,691.53 Median $2,884.03 Typical High $8,317.64 | Professional | None | $2,691.53 | $2,884.03 | $8,317.64 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $5,754.40 | Facility | None | $724.44 | $724.44 | $5,754.40 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $4,897.79 | Professional | None | $2,570.40 | $4,073.80 | $4,897.79 |
Molina Setting Professional Modifier None Typical Low $346.74 Median $2,884.03 Typical High $5,248.07 | Professional | None | $346.74 | $2,884.03 | $5,248.07 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $6,309.57 | Professional | None | $2,884.03 | $3,548.13 | $6,309.57 |
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 $1,778.28 Median $2,089.30 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,778.28 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $707.95 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,630.27 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $524.81 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $416.87 Typical High $416.87 | Professional | 56 · Pre-op care only | $354.81 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,951.21 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,951.21 | $2,951.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,288.25 Median $2,290.87 Typical High $2,570.40 | Professional | 51 · Multiple procedures | $1,288.25 | $2,290.87 | $2,570.40 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $512.86 Median $912.01 Typical High $1,023.29 | Professional | 80 · Assistant surgeon | $512.86 | $912.01 | $1,023.29 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $354.81 Median $645.65 Typical High $707.95 | Professional | 81 · Minimal assistant surgeon | $354.81 | $645.65 | $707.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $354.81 Median $645.65 Typical High $707.95 | Professional | 82 · Assistant surgeon, no resident | $354.81 | $645.65 | $707.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $645.65 Typical High $707.95 | Professional | AS · PA/NP assist | $354.81 | $645.65 | $707.95 |
Where South Carolina sits
The same service costs 21.9 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· 44th of 51
$3,236
AK $12,303TX $562
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.