How much rates vary
Facilitymedian $1,072 · 10th to 90th $437 to $8,511Professionalmedian $1,349 · 10th to 90th $158 to $1,995
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 $1,479.11 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,479.11 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,202.26 | $1,479.11 | $1,479.11 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,071.52 | $1,659.59 | $2,454.71 |
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 $1,348.96 Median $1,380.38 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,380.38 | $2,630.27 |
Medcost Setting Facility Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $3,388.44 | Facility | None | $1,071.52 | $1,479.11 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,412.54 | $1,621.81 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,202.26 Typical High $1,995.26 | Professional | None | $123.03 | $1,202.26 | $1,995.26 |
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 $1,174.90 Median $1,513.56 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,513.56 | $2,511.89 |
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 $602.56 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $602.56 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $239.88 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $891.25 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $177.83 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $120.23 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $831.76 | $1,047.13 | $1,047.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $2,454.71 Typical High $3,235.94 | Professional | 50 · Both sides | $2,137.96 | $2,454.71 | $3,235.94 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $812.83 Typical High $1,071.52 | Professional | 51 · Multiple procedures | $724.44 | $812.83 | $1,071.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $331.13 Typical High $436.52 | Professional | 80 · Assistant surgeon | $288.40 | $331.13 | $436.52 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $229.09 Typical High $302.00 | Professional | 81 · Minimal assistant surgeon | $199.53 | $229.09 | $302.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $229.09 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $229.09 | $302.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $229.09 Typical High $302.00 | Professional | AS · PA/NP assist | $199.53 | $229.09 | $302.00 |
Where South Carolina sits
The same service costs 5.9 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· 38th of 51
$1,349
AK $4,898TX $832
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.