How much rates vary
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 $5,248.07 Median $9,120.11 Typical High $22,908.68 | Facility | None | $5,248.07 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $4,365.16 Median $5,248.07 Typical High $5,248.07 | Professional | None | $4,365.16 | $5,248.07 | $5,248.07 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2,754.23 Median $3,019.95 Typical High $3,981.07 | Professional | None | $2,754.23 | $3,019.95 | $3,981.07 |
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 $4,365.16 Typical High $7,244.36 | Professional | None | $2,691.53 | $4,365.16 | $7,244.36 |
Medcost Setting Professional Modifier None Typical Low $2,754.23 Median $2,951.21 Typical High $10,232.93 | Professional | None | $2,754.23 | $2,951.21 | $10,232.93 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $7,079.46 | Facility | None | $724.44 | $724.44 | $7,079.46 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $5,011.87 Typical High $6,025.60 | Professional | None | $2,570.40 | $5,011.87 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $398.11 Median $3,630.78 Typical High $6,606.93 | Professional | None | $398.11 | $3,630.78 | $6,606.93 |
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 $3,311.31 Median $4,365.16 Typical High $7,762.47 | Professional | None | $3,311.31 | $4,365.16 | $7,762.47 |
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 $2,187.76 Median $2,630.27 Typical High $2,630.27 | Professional | 52 · Reduced service | $2,187.76 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $1,047.13 Typical High $1,047.13 | Professional | 53 · Discontinued | $870.96 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $3,890.45 Typical High $3,890.45 | Professional | 54 · Surgery only | $3,311.31 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $794.33 Typical High $794.33 | Professional | 55 · Aftercare only | $660.69 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $524.81 Typical High $524.81 | Professional | 56 · Pre-op care only | $436.52 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,090.30 Median $3,630.78 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $3,090.30 | $3,630.78 | $3,630.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,288.25 Median $2,818.38 Typical High $3,162.28 | Professional | 51 · Multiple procedures | $1,288.25 | $2,818.38 | $3,162.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $512.86 Median $1,122.02 Typical High $1,258.93 | Professional | 80 · Assistant surgeon | $512.86 | $1,122.02 | $1,258.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $363.08 Median $794.33 Typical High $891.25 | Professional | 81 · Minimal assistant surgeon | $363.08 | $794.33 | $891.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $363.08 Median $794.33 Typical High $891.25 | Professional | 82 · Assistant surgeon, no resident | $363.08 | $794.33 | $891.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $363.08 Median $794.33 Typical High $891.25 | Professional | AS · PA/NP assist | $363.08 | $794.33 | $891.25 |
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· 43rd of 51
$3,981
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.