How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,479 to $17,783Professionalmedian $1,096 · 10th to 90th $282 to $1,288
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 $1,096.48 Median $15,135.61 Typical High $24,547.09 | Facility | None | $1,096.48 | $15,135.61 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Ambetter Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,467.37 Median $6,918.31 Typical High $15,488.17 | Facility | None | $3,467.37 | $6,918.31 | $15,488.17 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,995.26 | Facility | None | $100.00 | $794.33 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,445.44 | Facility | None | $912.01 | $1,288.25 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $2,238.72 | Professional | None | $912.01 | $1,288.25 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $257.04 | Professional | None | $245.47 | $245.47 | $257.04 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
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 $537.03 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $758.58 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $3,311.31 Typical High $3,388.44 | Professional | 50 · Both sides | $1,949.84 | $3,311.31 | $3,388.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $1,096.48 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $645.65 | $1,096.48 | $1,122.02 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $436.52 Typical High $446.68 | Professional | 80 · Assistant surgeon | $257.04 | $436.52 | $446.68 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $181.97 Median $309.03 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $181.97 | $309.03 | $316.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $181.97 Median $309.03 Typical High $316.23 | Professional | 82 · Assistant surgeon, no resident | $181.97 | $309.03 | $316.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $309.03 Typical High $316.23 | Professional | AS · PA/NP assist | $181.97 | $309.03 | $316.23 |
Where South Carolina sits
The same service costs 104.7 times more in Wisconsin than in Montana. 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· 38th of 51
$1,096
WI $8,318MT $79.43
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.