How much rates vary
Facilitymedian $955 · 10th to 90th $457 to $8,511Professionalmedian $1,778 · 10th to 90th $275 to $2,692
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 $2,137.96 Median $9,120.11 Typical High $28,840.32 | Facility | None | $2,137.96 | $9,120.11 | $28,840.32 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,778.28 | $2,137.96 | $2,137.96 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $1,995.26 | Professional | None | $1,621.81 | $1,778.28 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,995.26 | Facility | None | $100.00 | $794.33 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,778.28 | $1,778.28 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,290.87 Typical High $4,168.69 | Professional | None | $2,137.96 | $2,290.87 | $4,168.69 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,884.03 | Facility | None | $724.44 | $724.44 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $2,454.71 | Professional | None | $1,905.46 | $2,041.74 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $1,659.59 Typical High $2,754.23 | Professional | None | $190.55 | $1,659.59 | $2,754.23 |
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 $1,479.11 Median $1,819.70 Typical High $3,090.30 | Professional | None | $1,479.11 | $1,819.70 | $3,090.30 |
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 $891.25 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $891.25 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $354.81 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,348.96 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $269.15 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $177.83 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,479.11 | $1,479.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $954.99 Median $1,071.52 Typical High $1,288.25 | Professional | 51 · Multiple procedures | $954.99 | $1,071.52 | $1,288.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $426.58 Typical High $512.86 | Professional | 80 · Assistant surgeon | $407.38 | $426.58 | $512.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $288.40 Median $302.00 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $288.40 | $302.00 | $363.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $288.40 Median $302.00 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $288.40 | $302.00 | $363.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $302.00 Typical High $363.08 | Professional | AS · PA/NP assist | $288.40 | $302.00 | $363.08 |
Where South Carolina sits
The same service costs 5.4 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
$1,778
AK $6,310TX $1,175
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.