How much rates vary
Facilitymedian $1,000 · 10th to 90th $437 to $8,511Professionalmedian $1,023 · 10th to 90th $102 to $1,514
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 $1,122.02 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,122.02 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,122.02 | Professional | None | $912.01 | $1,122.02 | $1,122.02 |
BCBS South Carolina Setting Professional Modifier None Typical Low $812.83 Median $1,230.27 Typical High $1,819.70 | Professional | None | $812.83 | $1,230.27 | $1,819.70 |
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 $1,047.13 Median $1,047.13 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,047.13 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,122.02 Typical High $2,511.89 | Facility | None | $831.76 | $1,122.02 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,230.27 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $912.01 Typical High $1,479.11 | Professional | None | $81.28 | $912.01 | $1,479.11 |
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 $912.01 Median $1,148.15 Typical High $1,905.46 | Professional | None | $912.01 | $1,148.15 | $1,905.46 |
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 $446.68 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $446.68 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $181.97 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $676.08 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $134.90 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $91.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $630.96 | $794.33 | $794.33 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,862.09 Typical High $2,454.71 | Professional | 50 · Both sides | $1,659.59 | $1,862.09 | $2,454.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $616.60 Typical High $812.83 | Professional | 51 · Multiple procedures | $562.34 | $616.60 | $812.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $251.19 Typical High $331.13 | Professional | 80 · Assistant surgeon | $223.87 | $251.19 | $331.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $173.78 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $154.88 | $173.78 | $229.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $173.78 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $173.78 | $229.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $173.78 Typical High $229.09 | Professional | AS · PA/NP assist | $154.88 | $173.78 | $229.09 |
Where South Carolina sits
The same service costs 5.6 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· 40th of 51
$1,023
AK $3,715UT $661
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.