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 $2,884.03 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,884.03 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,454.71 | $2,884.03 | $2,884.03 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $2,398.83 | Professional | None | $1,862.09 | $2,238.72 | $2,398.83 |
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 $2,454.71 Median $2,454.71 Typical High $3,981.07 | Professional | None | $2,454.71 | $2,454.71 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $2,818.38 Typical High $5,754.40 | Professional | None | $2,630.27 | $2,818.38 | $5,754.40 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $3,890.45 | Facility | None | $724.44 | $724.44 | $3,890.45 |
Medcost Setting Professional Modifier None Typical Low $2,454.71 Median $2,818.38 Typical High $3,019.95 | Professional | None | $2,454.71 | $2,818.38 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $1,949.84 Typical High $3,548.13 | Professional | None | $223.87 | $1,949.84 | $3,548.13 |
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 $2,041.74 Median $2,511.89 Typical High $4,168.69 | Professional | None | $2,041.74 | $2,511.89 | $4,168.69 |
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 $1,202.26 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,202.26 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $489.78 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,819.70 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $363.08 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $245.47 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,041.74 | $2,041.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,230.27 Median $1,479.11 Typical High $1,737.80 | Professional | 51 · Multiple procedures | $1,230.27 | $1,479.11 | $1,737.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $489.78 Median $588.84 Typical High $707.95 | Professional | 80 · Assistant surgeon | $489.78 | $588.84 | $707.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $346.74 Median $416.87 Typical High $489.78 | Professional | 81 · Minimal assistant surgeon | $346.74 | $416.87 | $489.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $346.74 Median $416.87 Typical High $489.78 | Professional | 82 · Assistant surgeon, no resident | $346.74 | $416.87 | $489.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $416.87 Typical High $489.78 | Professional | AS · PA/NP assist | $346.74 | $416.87 | $489.78 |
Where South Carolina sits
The same service costs 21.4 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· 44th of 51
$2,344
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.