How much rates vary
Facilitymedian $1,000 · 10th to 90th $437 to $8,511Professionalmedian $912 · 10th to 90th $100 to $1,479
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 $1,148.15 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,148.15 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,148.15 | Professional | None | $933.25 | $1,148.15 | $1,148.15 |
BCBS South Carolina Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $1,778.28 | Professional | None | $831.76 | $1,230.27 | $1,778.28 |
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 $1,071.52 Median $1,071.52 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,071.52 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $851.14 Median $1,148.15 Typical High $2,630.27 | Facility | None | $851.14 | $1,148.15 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,258.93 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $812.83 Typical High $1,445.44 | Professional | None | $85.11 | $812.83 | $1,445.44 |
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 $933.25 Median $1,174.90 Typical High $1,949.84 | Professional | None | $933.25 | $1,174.90 | $1,949.84 |
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 $467.74 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $467.74 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $186.21 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $691.83 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $138.04 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $93.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $645.65 | $812.83 | $812.83 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $1,905.46 Typical High $2,511.89 | Professional | 50 · Both sides | $1,698.24 | $1,905.46 | $2,511.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $630.96 Typical High $831.76 | Professional | 51 · Multiple procedures | $575.44 | $630.96 | $831.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $257.04 Typical High $338.84 | Professional | 80 · Assistant surgeon | $229.09 | $257.04 | $338.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $177.83 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $158.49 | $177.83 | $234.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $177.83 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $177.83 | $234.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $177.83 Typical High $234.42 | Professional | AS · PA/NP assist | $158.49 | $177.83 | $234.42 |
Where South Carolina sits
The same service costs 7.9 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· 46th of 51
$912
AK $3,802TX $479
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.