How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,514 to $14,125Professionalmedian $589 · 10th to 90th $110 to $912
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 $1,819.70 Median $4,265.80 Typical High $13,182.57 | Facility | None | $1,819.70 | $4,265.80 | $13,182.57 |
BCBS South Carolina Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $691.83 | Professional | None | $562.34 | $588.84 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,187.76 Typical High $3,388.44 | Facility | None | $602.56 | $2,187.76 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $977.24 | Professional | None | $588.84 | $616.60 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,412.54 | Professional | None | $741.31 | $794.33 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $1,659.59 Typical High $2,187.76 | Facility | None | $676.08 | $1,659.59 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $870.96 | Professional | None | $660.69 | $707.95 | $870.96 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $562.34 Typical High $912.01 | Professional | None | $75.86 | $562.34 | $912.01 |
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 $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $302.00 | $354.81 | $354.81 |
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 $446.68 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $446.68 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $89.13 | $107.15 | $107.15 |
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 $416.87 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $416.87 | $501.19 | $501.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,096.48 Typical High $1,288.25 | Professional | 50 · Both sides | $977.24 | $1,096.48 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $331.13 Median $363.08 Typical High $436.52 | Professional | 51 · Multiple procedures | $331.13 | $363.08 | $436.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $144.54 Typical High $173.78 | Professional | 80 · Assistant surgeon | $131.83 | $144.54 | $173.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $91.20 Median $102.33 Typical High $120.23 | Professional | 81 · Minimal assistant surgeon | $91.20 | $102.33 | $120.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $91.20 Median $102.33 Typical High $120.23 | Professional | 82 · Assistant surgeon, no resident | $91.20 | $102.33 | $120.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $102.33 Typical High $120.23 | Professional | AS · PA/NP assist | $91.20 | $102.33 | $120.23 |
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· 42nd of 51
$617
AK $2,455TX $417
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.