How much rates vary
Facilitymedian $891 · 10th to 90th $457 to $8,318Professionalmedian $1,122 · 10th to 90th $166 to $1,698
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 $1,348.96 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,348.96 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,348.96 | $1,348.96 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $1,202.26 | Professional | None | $1,047.13 | $1,096.48 | $1,202.26 |
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 $1,122.02 Median $1,122.02 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,122.02 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,412.54 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,819.70 | Facility | None | $724.44 | $724.44 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,148.15 | $1,318.26 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $1,071.52 Typical High $1,778.28 | Professional | None | $114.82 | $1,071.52 | $1,778.28 |
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 $954.99 Median $1,174.90 Typical High $1,949.84 | Professional | None | $954.99 | $1,174.90 | $1,949.84 |
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 $575.44 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $575.44 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $229.09 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $851.14 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $169.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $114.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $794.33 | $954.99 | $954.99 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $676.08 Typical High $831.76 | Professional | 51 · Multiple procedures | $575.44 | $676.08 | $831.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $269.15 Typical High $331.13 | Professional | 80 · Assistant surgeon | $229.09 | $269.15 | $331.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $162.18 Median $190.55 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $162.18 | $190.55 | $229.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $190.55 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $190.55 | $229.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $190.55 Typical High $229.09 | Professional | AS · PA/NP assist | $162.18 | $190.55 | $229.09 |
Where South Carolina sits
The same service costs 5.6 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
$1,122
AK $4,266TX $759
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.