How much rates vary
Facilitymedian $912 · 10th to 90th $457 to $8,318Professionalmedian $2,455 · 10th to 90th $380 to $3,715
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 $2,951.21 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,951.21 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,454.71 | $2,951.21 | $2,951.21 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2,290.87 Median $2,344.23 Typical High $2,630.27 | Professional | None | $2,290.87 | $2,344.23 | $2,630.27 |
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 $2,398.83 Median $2,454.71 Typical High $3,981.07 | Professional | None | $2,398.83 | $2,454.71 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $2,951.21 Median $3,162.28 Typical High $5,754.40 | Professional | None | $2,951.21 | $3,162.28 | $5,754.40 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $3,981.07 | Facility | None | $724.44 | $724.44 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $2,884.03 Typical High $3,311.31 | Professional | None | $2,630.27 | $2,884.03 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $2,290.87 Typical High $3,801.89 | Professional | None | $269.15 | $2,290.87 | $3,801.89 |
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 $2,454.71 Typical High $4,168.69 | Professional | None | $2,041.74 | $2,454.71 | $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 $1,230.27 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,230.27 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $489.78 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,862.09 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $371.54 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $245.47 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,737.80 | $2,041.74 | $2,041.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,318.26 Median $1,479.11 Typical High $1,778.28 | Professional | 51 · Multiple procedures | $1,318.26 | $1,479.11 | $1,778.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $588.84 Typical High $707.95 | Professional | 80 · Assistant surgeon | $524.81 | $588.84 | $707.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $371.54 Median $416.87 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $371.54 | $416.87 | $501.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $371.54 Median $416.87 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $371.54 | $416.87 | $501.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $416.87 Typical High $501.19 | Professional | AS · PA/NP assist | $371.54 | $416.87 | $501.19 |
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· 43rd of 51
$2,455
AK $8,710TX $1,622
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.