How much rates vary
Facilitymedian $912 · 10th to 90th $457 to $8,318Professionalmedian $1,738 · 10th to 90th $275 to $2,630
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 $2,089.30 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,089.30 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,778.28 | $2,089.30 | $2,089.30 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,737.80 | $1,862.09 |
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 $1,778.28 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,778.28 | $1,778.28 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,187.76 Typical High $4,168.69 | Professional | None | $2,041.74 | $2,187.76 | $4,168.69 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,818.38 | Facility | None | $724.44 | $724.44 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,344.23 | Professional | None | $1,819.70 | $2,041.74 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $1,621.81 Typical High $2,691.53 | Professional | None | $190.55 | $1,621.81 | $2,691.53 |
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 $1,479.11 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,479.11 | $1,819.70 | $3,019.95 |
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 $891.25 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $891.25 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $354.81 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,318.26 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $263.03 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $177.83 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,479.11 | $1,479.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $912.01 Median $1,071.52 Typical High $1,288.25 | Professional | 51 · Multiple procedures | $912.01 | $1,071.52 | $1,288.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $426.58 Typical High $512.86 | Professional | 80 · Assistant surgeon | $363.08 | $426.58 | $512.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $251.19 Median $302.00 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $251.19 | $302.00 | $354.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $251.19 Median $302.00 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $251.19 | $302.00 | $354.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $302.00 Typical High $354.81 | Professional | AS · PA/NP assist | $251.19 | $302.00 | $354.81 |
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· 45th of 51
$1,738
AK $6,166TX $1,148
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.