How much rates vary
Facilitymedian $912 · 10th to 90th $457 to $8,318Professionalmedian $1,318 · 10th to 90th $214 to $1,995
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 $1,584.89 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,584.89 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,584.89 | $1,584.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,230.27 | $1,318.26 | $1,479.11 |
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 $1,318.26 Median $1,318.26 Typical High $2,187.76 | Professional | None | $1,318.26 | $1,318.26 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $3,162.28 | Professional | None | $1,548.82 | $1,659.59 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,137.96 | Facility | None | $724.44 | $724.44 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,548.82 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $1,258.93 Typical High $2,089.30 | Professional | None | $151.36 | $1,258.93 | $2,089.30 |
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 $1,122.02 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,380.38 | $2,290.87 |
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 $660.69 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $660.69 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $269.15 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,000.00 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $199.53 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $134.90 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $1,122.02 | $1,122.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $676.08 Median $794.33 Typical High $954.99 | Professional | 51 · Multiple procedures | $676.08 | $794.33 | $954.99 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $323.59 Typical High $389.05 | Professional | 80 · Assistant surgeon | $269.15 | $323.59 | $389.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $223.87 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $190.55 | $223.87 | $269.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $223.87 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $223.87 | $269.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $223.87 Typical High $269.15 | Professional | AS · PA/NP assist | $190.55 | $223.87 | $269.15 |
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· 44th of 51
$1,318
AK $4,677TX $871
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.