How much rates vary
Facilitymedian $977 · 10th to 90th $437 to $8,511Professionalmedian $955 · 10th to 90th $102 to $1,413
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 $1,071.52 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,071.52 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,071.52 | Professional | None | $851.14 | $1,071.52 | $1,071.52 |
BCBS South Carolina Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,659.59 | Professional | None | $776.25 | $1,148.15 | $1,659.59 |
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 $977.24 Median $1,000.00 Typical High $1,905.46 | Professional | None | $977.24 | $1,000.00 | $1,905.46 |
Medcost Setting Facility Modifier None Typical Low $776.25 Median $1,071.52 Typical High $2,398.83 | Facility | None | $776.25 | $1,071.52 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,174.90 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $851.14 Typical High $1,380.38 | Professional | None | $81.28 | $851.14 | $1,380.38 |
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 $851.14 Median $1,096.48 Typical High $1,819.70 | Professional | None | $851.14 | $1,096.48 | $1,819.70 |
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 $426.58 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $426.58 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $173.78 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $645.65 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $128.82 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $85.11 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $602.56 | $758.58 | $758.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $588.84 Typical High $776.25 | Professional | 51 · Multiple procedures | $524.81 | $588.84 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $234.42 Typical High $309.03 | Professional | 80 · Assistant surgeon | $208.93 | $234.42 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $147.91 Median $165.96 Typical High $218.78 | Professional | 81 · Minimal assistant surgeon | $147.91 | $165.96 | $218.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $147.91 Median $165.96 Typical High $218.78 | Professional | 82 · Assistant surgeon, no resident | $147.91 | $165.96 | $218.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $165.96 Typical High $218.78 | Professional | AS · PA/NP assist | $147.91 | $165.96 | $218.78 |
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· 40th of 51
$955
AK $3,548TX $631
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.