How much rates vary
Facilitymedian $2,188 · 10th to 90th $955 to $14,125Professionalmedian $646 · 10th to 90th $107 to $933
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 $724.44 Median $10,964.78 Typical High $21,877.62 | Facility | None | $724.44 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $724.44 | Professional | None | $602.56 | $724.44 | $724.44 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $4,168.69 Typical High $13,182.57 | Facility | None | $1,047.13 | $4,168.69 | $13,182.57 |
BCBS South Carolina Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $741.31 | Professional | None | $562.34 | $724.44 | $741.31 |
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 $588.84 Median $616.60 Typical High $1,000.00 | Professional | None | $588.84 | $616.60 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,445.44 | Professional | None | $741.31 | $794.33 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $912.01 Typical High $2,089.30 | Facility | None | $630.96 | $912.01 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $870.96 | Professional | None | $707.95 | $724.44 | $870.96 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $562.34 Typical High $933.25 | Professional | None | $75.86 | $562.34 | $933.25 |
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 $501.19 Median $616.60 Typical High $1,023.29 | Professional | None | $501.19 | $616.60 | $1,023.29 |
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 $302.00 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $302.00 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $120.23 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $457.09 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $91.20 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $60.26 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $426.58 | $512.86 | $512.86 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,122.02 Typical High $1,412.54 | Professional | 50 · Both sides | $1,071.52 | $1,122.02 | $1,412.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $354.81 Median $371.54 Typical High $467.74 | Professional | 51 · Multiple procedures | $354.81 | $371.54 | $467.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $147.91 Typical High $186.21 | Professional | 80 · Assistant surgeon | $141.25 | $147.91 | $186.21 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $100.00 Median $104.71 Typical High $131.83 | Professional | 81 · Minimal assistant surgeon | $100.00 | $104.71 | $131.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $100.00 Median $104.71 Typical High $131.83 | Professional | 82 · Assistant surgeon, no resident | $100.00 | $104.71 | $131.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $104.71 Typical High $131.83 | Professional | AS · PA/NP assist | $100.00 | $104.71 | $131.83 |
Where South Carolina sits
The same service costs 5.9 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· 34th of 51
$676
AK $2,512TX $427
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.