How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,511Professionalmedian $1,660 · 10th to 90th $195 to $2,630
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 $1,905.46 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,905.46 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,548.82 | $1,905.46 | $1,905.46 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,584.89 | $2,630.27 |
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 $1,513.56 Median $1,737.80 Typical High $3,388.44 | Professional | None | $1,513.56 | $1,737.80 | $3,388.44 |
Medcost Setting Facility Modifier None Typical Low $1,288.25 Median $1,905.46 Typical High $4,265.80 | Facility | None | $1,288.25 | $1,905.46 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,862.09 Typical High $2,137.96 | Professional | None | $1,737.80 | $1,862.09 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $1,584.89 Typical High $2,630.27 | Professional | None | $165.96 | $1,584.89 | $2,630.27 |
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 $1,445.44 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,445.44 | $1,819.70 | $3,162.28 |
11 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 $776.25 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $776.25 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $309.03 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,174.90 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $234.42 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $154.88 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,348.96 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $870.96 Median $912.01 Typical High $1,380.38 | Professional | 51 · Multiple procedures | $870.96 | $912.01 | $1,380.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $371.54 Typical High $562.34 | Professional | 80 · Assistant surgeon | $346.74 | $371.54 | $562.34 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $245.47 Median $257.04 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $245.47 | $257.04 | $389.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $245.47 Median $257.04 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $245.47 | $257.04 | $389.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $257.04 Typical High $389.05 | Professional | AS · PA/NP assist | $245.47 | $257.04 | $389.05 |
Where South Carolina sits
The same service costs 5.6 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· 38th of 51
$1,660
AK $6,310TX $1,122
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.