How much rates vary
Facilitymedian $1,995 · 10th to 90th $631 to $16,982Professionalmedian $1,514 · 10th to 90th $158 to $2,239
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 $1,698.24 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,698.24 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,698.24 | $1,698.24 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,862.09 | $2,691.53 |
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 $1,548.82 Median $1,584.89 Typical High $3,019.95 | Professional | None | $1,548.82 | $1,584.89 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $3,801.89 | Facility | None | $1,258.93 | $1,698.24 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $2,041.74 | Professional | None | $1,584.89 | $1,819.70 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,348.96 Typical High $2,187.76 | Professional | None | $123.03 | $1,348.96 | $2,187.76 |
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 $1,380.38 Median $1,737.80 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,737.80 | $2,884.03 |
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 $676.08 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $269.15 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,023.29 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $204.17 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $134.90 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $954.99 | $1,174.90 | $1,174.90 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,570.40 Median $2,754.23 Typical High $3,715.35 | Professional | 50 · Both sides | $2,570.40 | $2,754.23 | $3,715.35 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $851.14 Median $912.01 Typical High $1,230.27 | Professional | 51 · Multiple procedures | $851.14 | $912.01 | $1,230.27 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $363.08 Typical High $489.78 | Professional | 80 · Assistant surgeon | $338.84 | $363.08 | $489.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $239.88 Median $257.04 Typical High $346.74 | Professional | 81 · Minimal assistant surgeon | $239.88 | $257.04 | $346.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $239.88 Median $257.04 Typical High $346.74 | Professional | 82 · Assistant surgeon, no resident | $239.88 | $257.04 | $346.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $257.04 Typical High $346.74 | Professional | AS · PA/NP assist | $239.88 | $257.04 | $346.74 |
Where South Carolina sits
The same service costs 5.8 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· 41st of 51
$1,549
AK $5,623UT $977
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.