How much rates vary
Facilitymedian $4,898 · 10th to 90th $631 to $11,220Professionalmedian $490 · 10th to 90th $288 to $724
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 $549.54 Median $5,623.41 Typical High $21,877.62 | Facility | None | $549.54 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $549.54 | Professional | None | $416.87 | $549.54 | $549.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,630.78 Median $6,165.95 Typical High $10,715.19 | Facility | None | $3,630.78 | $6,165.95 | $10,715.19 |
BCBS South Carolina Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $776.25 | Professional | None | $371.54 | $512.86 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,096.48 Typical High $1,548.82 | Facility | None | $457.09 | $1,096.48 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $478.63 Typical High $912.01 | Professional | None | $467.74 | $478.63 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $1,202.26 Typical High $1,621.81 | Facility | None | $467.74 | $1,202.26 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $616.60 | Professional | None | $426.58 | $489.78 | $616.60 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $457.09 Typical High $707.95 | Professional | None | $66.07 | $457.09 | $707.95 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $870.96 | Professional | None | $407.38 | $489.78 | $870.96 |
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 $204.17 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $204.17 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $83.18 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $309.03 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $61.66 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $41.69 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $288.40 | $380.19 | $380.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $812.83 Typical High $1,174.90 | Professional | 50 · Both sides | $645.65 | $812.83 | $1,174.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $213.80 Median $275.42 Typical High $389.05 | Professional | 51 · Multiple procedures | $213.80 | $275.42 | $389.05 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $109.65 Typical High $151.36 | Professional | 80 · Assistant surgeon | $85.11 | $109.65 | $151.36 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $60.26 Median $75.86 Typical High $104.71 | Professional | 81 · Minimal assistant surgeon | $60.26 | $75.86 | $104.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $60.26 Median $75.86 Typical High $104.71 | Professional | 82 · Assistant surgeon, no resident | $60.26 | $75.86 | $104.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $75.86 Typical High $104.71 | Professional | AS · PA/NP assist | $60.26 | $75.86 | $104.71 |
Where South Carolina sits
The same service costs 5.1 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
$513
AK $1,698UT $331
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.