How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,479 to $28,184Professionalmedian $776 · 10th to 90th $100 to $1,096
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 $912.01 Median $15,135.61 Typical High $24,547.09 | Facility | None | $912.01 | $15,135.61 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $912.01 | Professional | None | $758.58 | $912.01 | $912.01 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $8,317.64 Typical High $29,512.09 | Facility | None | $1,905.46 | $8,317.64 | $29,512.09 |
BCBS South Carolina Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $954.99 | Professional | None | $691.83 | $891.25 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,311.31 Typical High $4,677.35 | Facility | None | $630.96 | $3,311.31 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $1,230.27 | Professional | None | $776.25 | $812.83 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,071.52 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $660.69 Median $724.44 Typical High $2,089.30 | Facility | None | $660.69 | $724.44 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $912.01 Typical High $1,230.27 | Professional | None | $870.96 | $912.01 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $602.56 Typical High $1,096.48 | Professional | None | $81.28 | $602.56 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,318.26 | Professional | None | $630.96 | $776.25 | $1,318.26 |
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 $380.19 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $380.19 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $151.36 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $562.34 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $112.20 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $75.86 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $524.81 | $630.96 | $630.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $478.63 Typical High $660.69 | Professional | 51 · Multiple procedures | $436.52 | $478.63 | $660.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $190.55 Typical High $263.03 | Professional | 80 · Assistant surgeon | $173.78 | $190.55 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $131.83 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $123.03 | $131.83 | $186.21 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $131.83 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $131.83 | $186.21 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $131.83 Typical High $186.21 | Professional | AS · PA/NP assist | $123.03 | $131.83 | $186.21 |
Where South Carolina sits
The same service costs 25.1 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· 41st of 51
$776
AK $3,090TX $123
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.