How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,511Professionalmedian $1,585 · 10th to 90th $135 to $2,570
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 $1,995.26 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,995.26 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,995.26 | $1,995.26 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,412.54 | $2,187.76 | $3,162.28 |
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 $1,819.70 Median $1,862.09 Typical High $3,548.13 | Professional | None | $1,819.70 | $1,862.09 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $4,466.84 | Facility | None | $1,513.56 | $1,995.26 | $4,466.84 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,398.83 | Professional | None | $1,862.09 | $2,089.30 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $1,380.38 Typical High $2,511.89 | Professional | None | $128.82 | $1,380.38 | $2,511.89 |
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 $1,584.89 Median $1,995.26 Typical High $3,388.44 | Professional | None | $1,584.89 | $1,995.26 | $3,388.44 |
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 $794.33 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $794.33 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $323.59 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,202.26 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $239.88 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $158.49 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,412.54 | $1,412.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,023.29 Median $1,071.52 Typical High $1,445.44 | Professional | 51 · Multiple procedures | $1,023.29 | $1,071.52 | $1,445.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $426.58 Typical High $575.44 | Professional | 80 · Assistant surgeon | $407.38 | $426.58 | $575.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $281.84 Median $302.00 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $281.84 | $302.00 | $407.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $281.84 Median $302.00 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $281.84 | $302.00 | $407.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $302.00 Typical High $407.38 | Professional | AS · PA/NP assist | $281.84 | $302.00 | $407.38 |
Where South Carolina sits
The same service costs 6.8 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· 47th of 51
$1,585
AK $6,607TX $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.