How much rates vary
Facilitymedian $1,479 · 10th to 90th $513 to $6,166Professionalmedian $269 · 10th to 90th $52 to $437
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 $316.23 Median $5,623.41 Typical High $21,877.62 | Facility | None | $316.23 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $316.23 | Professional | None | $269.15 | $316.23 | $316.23 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,412.54 Typical High $5,495.41 | Facility | None | $512.86 | $1,412.54 | $5,495.41 |
BCBS South Carolina Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $275.42 | Professional | None | $213.80 | $239.88 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $2,398.83 | Facility | None | $602.56 | $1,621.81 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $223.87 Typical High $426.58 | Professional | None | $208.93 | $223.87 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $630.96 | Professional | None | $257.04 | $275.42 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $251.19 Median $912.01 Typical High $1,230.27 | Facility | None | $251.19 | $912.01 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $263.03 Typical High $309.03 | Professional | None | $245.47 | $263.03 | $309.03 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $281.84 Typical High $478.63 | Professional | None | $37.15 | $281.84 | $478.63 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $389.05 | Professional | None | $208.93 | $251.19 | $389.05 |
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 $134.90 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $134.90 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $53.70 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $239.88 Typical High $239.88 | Professional | 54 · Surgery only | $199.53 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $39.81 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.92 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $223.87 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $186.21 | $223.87 | $223.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $131.83 Typical High $194.98 | Professional | 51 · Multiple procedures | $120.23 | $131.83 | $194.98 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $52.48 Typical High $77.62 | Professional | 80 · Assistant surgeon | $48.98 | $52.48 | $77.62 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.88 Median $37.15 Typical High $53.70 | Professional | 81 · Minimal assistant surgeon | $33.88 | $37.15 | $53.70 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.88 Median $37.15 Typical High $53.70 | Professional | 82 · Assistant surgeon, no resident | $33.88 | $37.15 | $53.70 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $33.88 Median $37.15 Typical High $53.70 | Professional | AS · PA/NP assist | $33.88 | $37.15 | $53.70 |
Where South Carolina sits
The same service costs 5.2 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· 39th of 51
$275
AK $1,122TX $214
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.