How much rates vary
Facilitymedian $2,239 · 10th to 90th $933 to $14,125Professionalmedian $457 · 10th to 90th $302 to $676
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 $478.63 Median $10,964.78 Typical High $21,877.62 | Facility | None | $478.63 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $478.63 | Professional | None | $398.11 | $478.63 | $478.63 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $4,365.16 Typical High $13,182.57 | Facility | None | $1,047.13 | $4,365.16 | $13,182.57 |
BCBS South Carolina Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $676.08 | Professional | None | $380.19 | $575.44 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,905.46 Typical High $2,951.21 | Facility | None | $630.96 | $1,905.46 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $416.87 Typical High $660.69 | Professional | None | $398.11 | $416.87 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $954.99 | Professional | None | $501.19 | $537.03 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $912.01 Typical High $2,089.30 | Facility | None | $436.52 | $912.01 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $478.63 Typical High $812.83 | Professional | None | $467.74 | $478.63 | $812.83 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $398.11 Typical High $630.96 | Professional | None | $58.88 | $398.11 | $630.96 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $676.08 | Professional | None | $331.13 | $407.38 | $676.08 |
12 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 $199.53 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $199.53 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $81.28 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $302.00 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $60.26 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $39.81 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $338.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $281.84 | $338.84 | $338.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $812.83 Typical High $1,230.27 | Professional | 50 · Both sides | $707.95 | $812.83 | $1,230.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $239.88 Median $275.42 Typical High $407.38 | Professional | 51 · Multiple procedures | $239.88 | $275.42 | $407.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $109.65 Typical High $162.18 | Professional | 80 · Assistant surgeon | $95.50 | $109.65 | $162.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $66.07 Median $75.86 Typical High $114.82 | Professional | 81 · Minimal assistant surgeon | $66.07 | $75.86 | $114.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $66.07 Median $75.86 Typical High $114.82 | Professional | 82 · Assistant surgeon, no resident | $66.07 | $75.86 | $114.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $75.86 Typical High $114.82 | Professional | AS · PA/NP assist | $66.07 | $75.86 | $114.82 |
Where South Carolina sits
The same service costs 5.6 times more in Alaska than in Utah. 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· 34th of 51
$468
AK $1,660UT $295
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.